Antiretroviral Therapy in Pregnancy: Role of ART in adverse pregnancy outcome, infant growth and maternal health

Abstract

This thesis aimed to investigate the differential roles of antiretroviral regimens in pregnancy outcome and maternal and offspring health. Data was abstracted from clinical records of HIV-infected pregnant women and their infants from health facilities in Addis Ababa, Ethiopia. Our findings showed that combination ART initiated during pregnancy was associated with a higher risk of preterm birth and low birthweight as compared to zidovudine-monotherapy. We also observed a moderate risk of stunting among infants associated with ART exposure since conception as compared to ART exposure since late pregnancy. Early ART, as opposed to delaying treatment, for asymptomatic women with intact immunity, was found to be beneficial to preserve immunity. In conclusion, our findings highlights the health benefits of early initiation of ART, even for asymptomatic HIV-infected women, but the findings also suggest the potential role of ART in increasing risk of adverse pregnancy outcomes and infant growth restriction. In light of the findings, early initiation of ART should be promoted, but HIV-infected pregnant women on ART and their infants should be closely monitored.