Protease inhibitors and decreased birth weight in HIV-infected pregnant women with impaired glucose tolerance

Abstract

Objective: To assess the impact of highly active antiretroviral therapy, including a protease inhibitor (HAART/PI), on maternal glucose tolerance and fetal growth. Study Design: A retrospective chart review of pregnancy outcomes of human immunodeficiency virus-infected pregnant women receiving HAART/PI (n = 41) or zidovudine monotherapy (n = 23). Results: Abnormal 1-hour glucose tolerance tests (1hGTT) were observed in 30% of subjects receiving HAART/PI between 24 and 28 weeks' gestation. An elevated 1hGTT was associated with a significantly lower mean birth weight in subjects receiving HAART/PI compared to babies born to mothers with a normal 1hGTT (3.40 ± 0.09 vs 3.00 ± 0.18 kg, p<0.05, ANOVA). Conclusion: HAART/PI therapy is associated with an increased rate of impaired glucose tolerance in pregnancy and impaired fetal growth. This finding merits further investigation.