No increase in birth defects: antiretroviral combos tied to rise in preterm births.(Obstetrics)

NEW ORLEANS -- Antiretroviral exposure during pregnancy is not associated with an increased risk of birth defects, but certain antiretroviral drug combinations may increase the risk of preterm delivery, studies presented at the annual meeting of the Society for Maternal-Fetal Medicine suggest.

In one study, the incidence of birth defects did not differ between the general population and nearly 3,800 babies born to women in the Antiretroviral Pregnancy Registry between 1989 and 2003.

The incidence of birth defects in the Atlanta metropolitan area was approximately 3.1%, according to Centers for Disease Control and Prevention data, and the incidence among registry participants was 2.8%, said Dr. Karen Beckerman of New York University, New York.

Of the patients in the registry during the study period, 42% reported first-trimester antiretroviral exposure, and about one-third were exposed to potent combinations of highly active antiretroviral drugs and protease inhibitors. The remaining patients were exposed to various drug combinations, including suboptimal therapy and combinations rarely used in the United States.

Furthermore, no link was detected between birth defects and any of the five antiretroviral agents--lamivudine, nelfinavir, nevirapine, stavudine, and zidovudine--for which there were enough data to allow individual analysis.

In a separate study presented at the meeting, exposure during pregnancy ...