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Preterm Birth and Antiretroviral Exposure in Infants HIV-Exposed Uninfected Piske, Micah; Qiu, Annie Q.; Maan, Evelyn J.; Sauvé, Laura; Forbes, John C.; Alimenti, Ariane; Janssen, Patricia A.; Money, Deborah M.; Côté, Hélène C. F.

Abstract

Background: Infants who are HIV-exposed and uninfected (IHEU) born to women living with HIV (WLWH) are at an increased risk of preterm birth (PTB). Antenatal exposure to certain maternal antiretroviral therapy (ART) regimens has been associated with PTB, although existing studies in this domain have been limited with discordant findings. We determined odds of PTB among IHEU by antenatal ART regimens and exposure durations, adjusting for maternal risk factors. Methods: We retrospectively studied IHEU born in British Columbia (BC), Canada between 1990 to 2012 utilizing provincial health administrative databases. Data was collected for infants HIV-unexposed and uninfected (IHUU) controls matched ~3:1 for each IHEU on age, sex and geocode. We determined adjusted odds ratios (AORs) of PTB via multivariable logistic regression. Results: A total of 411 IHEU and 1224 IHUU were included in univariate analysis. PTB was more frequent among IHEU compared to IHUU (20% vs. 7%). IHEU were more often antenatally exposed to alcohol, tobacco, and prescription, non-prescription, and illicit drugs (IHEU: 36%, 8%, 35%; IHUU: 3%, 1%, 9% respectively). After adjusting for maternal substance use and smoking exposure, IHEU remained at increased odds of PTB [AOR:2.66; 1.73, 4.08] compared to matched IHUU controls. ART-exposed IHEU had lower adjusted odds of PTB compared to IHEU with no maternal ART exposure, regardless of regimen (excluding NRTIs only) (AOR: 0.16-0.29[0.02-0.95]) or exposure durations (AOR:0.16-0.25 [0.06-0.78]). Conclusions: BC IHEU were over twice as likely to be born preterm compared to demographically matched controls. While maternal substance use in pregnancy modulated this risk, we found no adverse associations of PTB with antenatal ART regimens or exposure durations.

Item Metadata

Title
Preterm Birth and Antiretroviral Exposure in Infants HIV-Exposed Uninfected
Alternate Title
Preterm Birth in Infants HIV-Exposed Uninfected
Creator
Piske, Micah; Qiu, Annie Q.; Maan, Evelyn J.; Sauvé, Laura; Forbes, John C.; Alimenti, Ariane; Janssen, Patricia A.; Money, Deborah M.; Côté, Hélène C. F.
Contributor
Women's Health Research Institute (British Columbia); Women's Hospital (Vancouver, B.C.)
Date Issued
2021-03
Description
Background: Infants who are HIV-exposed and uninfected (IHEU) born to women living with HIV (WLWH) are at an increased risk of preterm birth (PTB). Antenatal exposure to certain maternal antiretroviral therapy (ART) regimens has been associated with PTB, although existing studies in this domain have been limited with discordant findings. We determined odds of PTB among IHEU by antenatal ART regimens and exposure durations, adjusting for maternal risk factors. Methods: We retrospectively studied IHEU born in British Columbia (BC), Canada between 1990 to 2012 utilizing provincial health administrative databases. Data was collected for infants HIV-unexposed and uninfected (IHUU) controls matched ~3:1 for each IHEU on age, sex and geocode. We determined adjusted odds ratios (AORs) of PTB via multivariable logistic regression. Results: A total of 411 IHEU and 1224 IHUU were included in univariate analysis. PTB was more frequent among IHEU compared to IHUU (20% vs. 7%). IHEU were more often antenatally exposed to alcohol, tobacco, and prescription, non-prescription, and illicit drugs (IHEU: 36%, 8%, 35%; IHUU: 3%, 1%, 9% respectively). After adjusting for maternal substance use and smoking exposure, IHEU remained at increased odds of PTB [AOR:2.66; 1.73, 4.08] compared to matched IHUU controls. ART-exposed IHEU had lower adjusted odds of PTB compared to IHEU with no maternal ART exposure, regardless of regimen (excluding NRTIs only) (AOR: 0.16-0.29[0.02-0.95]) or exposure durations (AOR:0.16-0.25 [0.06-0.78]). Conclusions: BC IHEU were over twice as likely to be born preterm compared to demographically matched controls. While maternal substance use in pregnancy modulated this risk, we found no adverse associations of PTB with antenatal ART regimens or exposure durations.
Subject
HIV-exposed uninfected; IHEU; HIV infant; preterm birth; maternal antiretroviral therapy; maternal HIV
Genre
Article; Postprint
Type
Text
Language
eng
Date Available
2024-06-11
Provider
Vancouver : University of British Columbia Library
Rights
Attribution-NonCommercial-NoDerivatives 4.0 International
DOI
10.14288/1.0443956
URI
http://hdl.handle.net/2429/88457
Affiliation
Medicine, Faculty of; Other UBC; Obstetrics and Gynaecology, Department of; Pathology and Laboratory Medicine, Department of; Pediatrics, Department of; Population and Public Health (SPPH), School of
Citation
Piske M, Qiu A, Maan E, Sauvé L, Forbes J, Alimenti A, Janssen P, Money D, Côté H. Preterm Birth and Antiretroviral Exposure in Infants HIV-exposed Uninfected. The Pediatric Infectious Disease Journal 2021; 45: 245-250.
Publisher DOI
10.1097/inf.0000000000002984
Peer Review Status
Reviewed
Scholarly Level
Faculty; Researcher
Rights URI
http://creativecommons.org/licenses/by-nc-nd/4.0/
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Attribution-NonCommercial-NoDerivatives 4.0 International