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Quantitative Structure-Activity Relationship, Activity Prediction, and Molecular Dynamics of Non-nucleotide Reverse Transcriptase Inhibitors
Published on: May 9, 2025
Combination antiretroviral use and preterm birth
D Heather Watts1, Paige L Williams, Deborah Kacanek
1Pediatric, Adolescent, and Maternal AIDS Branch, Eunice Kennedy Shriver National Institute for Child Health and Human Development, Bethesda, Maryland, USA. hw59i@nih.gov
The Journal of Infectious Diseases
|December 4, 2012
Summary
Protease inhibitor use in early pregnancy increases preterm birth risk. Antiretroviral drug exposure later in pregnancy did not show increased risk for preterm birth or small for gestational age.
Area of Science:
- Obstetrics and Gynecology
- Pediatric Health
- Infectious Diseases
Background:
- Antiretroviral drugs (ARVs) use in pregnancy is linked to increased preterm birth risk.
- Understanding specific ARV risks is crucial for maternal and infant health outcomes.
Purpose of the Study:
- To evaluate the association between maternal ARV use during pregnancy and the risk of preterm birth, spontaneous preterm birth, and small for gestational age (SGA).
Main Methods:
- Analysis of data from the US-based Surveillance Monitoring for ART Toxicities study, a cohort of HIV-exposed uninfected children.
- Multivariable logistic regression models assessed ARV exposure timing and risk of adverse birth outcomes.
- Adjusted for maternal characteristics to isolate ARV effects.
Main Results:
- 18.6% of singleton births were preterm, 10.2% spontaneous preterm, and 7.3% SGA.
- Protease inhibitor use in the first trimester significantly increased odds of preterm birth (aOR 1.55) and spontaneous preterm birth (aOR 1.59).
- No increased risk observed for nonnucleoside reverse-transcriptase inhibitor or triple-nucleoside regimens, later ARV exposure, or SGA.
Conclusions:
- Early pregnancy protease inhibitor use may be associated with a higher risk of prematurity.
- Timing of antiretroviral therapy initiation is a critical factor in pregnancy outcomes.
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