Birth outcomes improve for HIV-exposed infants.

Between 1989 and 2004, a span including the introduction of antiretroviral therapy for pregnant HIV-positive women and their infants, birth outcomes in a large longitudinal perinatal and HIV study improved dramatically. (1) The proportion of infants born to infected mothers who were low-birth-weight declined from 35% to 21%; the proportion delivered preterm fell from 35% to 22%. Declines occurred among blacks, whites and Hispanics. No association was found between use of antiretroviral therapy and the risk of having a low-birth-weight baby, but nonuse of antiretroviral drugs and use of highly active antiretroviral therapy including a protease inhibitor were associated with increased risks of preterm delivery among women who received prenatal care. Noting that the study cannot establish whether access to antiretroviral therapy is responsible for the observed trends in this cohort, the researchers stress the need for "ongoing surveillance ... to monitor pregnancy outcomes as more HIV-infected women choose to bear children."

(1.) Schulte J et al., Declines in low birth weight and preterm birth among infants who were born to HIV-infected women during an era of increased use of maternal antiretroviral drugs: Pediatric Spectrum of HIV Disease, 1989-2004, Pediatrics, 2007, 119(4):e900-e906.

FYI is compiled and written by Dore Hollander, executive editor of Perspectives on Sexual and Reproductive Health.