OBJECTIVE: Although zidovudine-free regimens are increasingly used in pregnancy, their haematological effects in mothers and newborns are incompletely defined.METHODS: The haematological profiles of 119 HIV-infected women and their neonates with highly active antiretroviral regimens (HAART) in pregnancy including or not zidovudine (ZDV) were investigated. Three groups were compared: 1) women who started ZDV-lamivudine (3TC)-based HAART during pregnancy (ZDVs, n = 60); 2) women on ZDV-3TC-based HAART from conception (ZDVc, n = 18); 3) women on ZDV-free HAART from conception (ZDVf, n = 41).RESULTS: At the beginning of pregnancy, haemoglobin levels were similar in the three groups. By week 36 compared to baseline, haemoglobin levels had a significantly greater decrease in ZDVf women compared to ZDVs women (ZDVf: -2.03 g/dl; ZDVs: -1.36 g/dl, p = 0.036). A similar trend was observed for occurrence of maternal anaemia at 36 weeks. Newborns with no prenatal ZDV exposure had significantly higher haemoglobin levels at birth (ZDVf: 16.1 ± 1.4 g/dl, ZDVs: 14.3 ± 2.0 g/dl; ZDVc: 14.6 ± 2.4 g/dl, p = 0.044 and 0.003, respectively).CONCLUSIONS: Half of ZDV-unexposed mothers had anaemia at the end of pregnancy, but their neonates had normal haemoglobin levels. ZDV initiation was associated with a lower occurrence of maternal anaemia during the third trimester and decreased haemoglobin levels in the newborns. We hypothesize that foetal iron requirements could represent a major determinant of maternal anaemia at the end of pregnancy.

Common occurrence of anaemia at the end of pregnancy following exposure to zidovudine-free regimens / C., Pinnetti; S., Baroncelli; A., Molinari; Nardini, Giulia; O., Genovese; B. M., Ricerca; A. F., Cavaliere; Guaraldi, Giovanni; A. D., Antoni; E., Tamburrini; M., Floridia. - In: JOURNAL OF INFECTION. - ISSN 0163-4453. - STAMPA. - 63:(2011), pp. 144-150. [10.1016/j.jinf.2011.06.001]

Common occurrence of anaemia at the end of pregnancy following exposure to zidovudine-free regimens.

NARDINI, Giulia;GUARALDI, Giovanni;
2011

Abstract

OBJECTIVE: Although zidovudine-free regimens are increasingly used in pregnancy, their haematological effects in mothers and newborns are incompletely defined.METHODS: The haematological profiles of 119 HIV-infected women and their neonates with highly active antiretroviral regimens (HAART) in pregnancy including or not zidovudine (ZDV) were investigated. Three groups were compared: 1) women who started ZDV-lamivudine (3TC)-based HAART during pregnancy (ZDVs, n = 60); 2) women on ZDV-3TC-based HAART from conception (ZDVc, n = 18); 3) women on ZDV-free HAART from conception (ZDVf, n = 41).RESULTS: At the beginning of pregnancy, haemoglobin levels were similar in the three groups. By week 36 compared to baseline, haemoglobin levels had a significantly greater decrease in ZDVf women compared to ZDVs women (ZDVf: -2.03 g/dl; ZDVs: -1.36 g/dl, p = 0.036). A similar trend was observed for occurrence of maternal anaemia at 36 weeks. Newborns with no prenatal ZDV exposure had significantly higher haemoglobin levels at birth (ZDVf: 16.1 ± 1.4 g/dl, ZDVs: 14.3 ± 2.0 g/dl; ZDVc: 14.6 ± 2.4 g/dl, p = 0.044 and 0.003, respectively).CONCLUSIONS: Half of ZDV-unexposed mothers had anaemia at the end of pregnancy, but their neonates had normal haemoglobin levels. ZDV initiation was associated with a lower occurrence of maternal anaemia during the third trimester and decreased haemoglobin levels in the newborns. We hypothesize that foetal iron requirements could represent a major determinant of maternal anaemia at the end of pregnancy.
63
144
150
Common occurrence of anaemia at the end of pregnancy following exposure to zidovudine-free regimens / C., Pinnetti; S., Baroncelli; A., Molinari; Nardini, Giulia; O., Genovese; B. M., Ricerca; A. F., Cavaliere; Guaraldi, Giovanni; A. D., Antoni; E., Tamburrini; M., Floridia. - In: JOURNAL OF INFECTION. - ISSN 0163-4453. - STAMPA. - 63:(2011), pp. 144-150. [10.1016/j.jinf.2011.06.001]
C., Pinnetti; S., Baroncelli; A., Molinari; Nardini, Giulia; O., Genovese; B. M., Ricerca; A. F., Cavaliere; Guaraldi, Giovanni; A. D., Antoni; E., Tamburrini; M., Floridia
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11380/656039
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