Common occurrence of anaemia at the end of pregnancy following exposure to zidovudine-free regimens

Carmela Pinnetti, Silvia Baroncelli, Atim Molinari, Giulia Nardini, Orazio Genovese, Bianca Maria Ricerca, Anna Franca Cavaliere, Giovanni Guaraldi, Anna Degli Antoni, Enrica Tamburrini, Marco Floridia

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Abstract

Objective: Although zidovudine-free regimens are increasingly used in pregnancy, their haematological effects in mothers and newborns are incompletely defined. Methods: The haematological profiles of 119 HIV-infected women and their neonates with highly active antiretroviral regimens (HAART) in pregnancy including or not zidovudine (ZDV) were investigated. Three groups were compared: 1) women who started ZDV-lamivudine (3TC)-based HAART during pregnancy (ZDVs, n = 60); 2) women on ZDV-3TC-based HAART from conception (ZDVc, n = 18); 3) women on ZDV-free HAART from conception (ZDVf, n = 41). Results: At the beginning of pregnancy, haemoglobin levels were similar in the three groups. By week 36 compared to baseline, haemoglobin levels had a significantly greater decrease in ZDVf women compared to ZDVs women (ZDVf: -2.03 g/dl; ZDVs: -1.36 g/dl, p = 0.036). A similar trend was observed for occurrence of maternal anaemia at 36 weeks. Newborns with no prenatal ZDV exposure had significantly higher haemoglobin levels at birth (ZDVf: 16.1 ± 1.4 g/dl, ZDVs: 14.3 ± 2.0 g/dl; ZDVc: 14.6 ± 2.4 g/dl, p = 0.044 and 0.003, respectively). Conclusions: Half of ZDV-unexposed mothers had anaemia at the end of pregnancy, but their neonates had normal haemoglobin levels. ZDV initiation was associated with a lower occurrence of maternal anaemia during the third trimester and decreased haemoglobin levels in the newborns. We hypothesize that foetal iron requirements could represent a major determinant of maternal anaemia at the end of pregnancy.

Original languageEnglish
Pages (from-to)144-150
Number of pages7
JournalJournal of Infection
Volume63
Issue number2
DOIs
Publication statusPublished - Aug 2011

Fingerprint

Zidovudine
Anemia
Pregnancy
Hemoglobins
Mothers
Newborn Infant
Lamivudine
Third Pregnancy Trimester
Iron
HIV
Parturition

Keywords

  • Anaemia
  • Antiretroviral treatment
  • HIV
  • Pregnancy
  • Tenofovir
  • Zidovudine

ASJC Scopus subject areas

  • Infectious Diseases
  • Microbiology (medical)

Cite this

Pinnetti, C., Baroncelli, S., Molinari, A., Nardini, G., Genovese, O., Ricerca, B. M., ... Floridia, M. (2011). Common occurrence of anaemia at the end of pregnancy following exposure to zidovudine-free regimens. Journal of Infection, 63(2), 144-150. https://doi.org/10.1016/j.jinf.2011.06.001

Common occurrence of anaemia at the end of pregnancy following exposure to zidovudine-free regimens. / Pinnetti, Carmela; Baroncelli, Silvia; Molinari, Atim; Nardini, Giulia; Genovese, Orazio; Ricerca, Bianca Maria; Cavaliere, Anna Franca; Guaraldi, Giovanni; Antoni, Anna Degli; Tamburrini, Enrica; Floridia, Marco.

In: Journal of Infection, Vol. 63, No. 2, 08.2011, p. 144-150.

Research output: Contribution to journalArticle

Pinnetti, C, Baroncelli, S, Molinari, A, Nardini, G, Genovese, O, Ricerca, BM, Cavaliere, AF, Guaraldi, G, Antoni, AD, Tamburrini, E & Floridia, M 2011, 'Common occurrence of anaemia at the end of pregnancy following exposure to zidovudine-free regimens', Journal of Infection, vol. 63, no. 2, pp. 144-150. https://doi.org/10.1016/j.jinf.2011.06.001
Pinnetti, Carmela ; Baroncelli, Silvia ; Molinari, Atim ; Nardini, Giulia ; Genovese, Orazio ; Ricerca, Bianca Maria ; Cavaliere, Anna Franca ; Guaraldi, Giovanni ; Antoni, Anna Degli ; Tamburrini, Enrica ; Floridia, Marco. / Common occurrence of anaemia at the end of pregnancy following exposure to zidovudine-free regimens. In: Journal of Infection. 2011 ; Vol. 63, No. 2. pp. 144-150.
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abstract = "Objective: Although zidovudine-free regimens are increasingly used in pregnancy, their haematological effects in mothers and newborns are incompletely defined. Methods: The haematological profiles of 119 HIV-infected women and their neonates with highly active antiretroviral regimens (HAART) in pregnancy including or not zidovudine (ZDV) were investigated. Three groups were compared: 1) women who started ZDV-lamivudine (3TC)-based HAART during pregnancy (ZDVs, n = 60); 2) women on ZDV-3TC-based HAART from conception (ZDVc, n = 18); 3) women on ZDV-free HAART from conception (ZDVf, n = 41). Results: At the beginning of pregnancy, haemoglobin levels were similar in the three groups. By week 36 compared to baseline, haemoglobin levels had a significantly greater decrease in ZDVf women compared to ZDVs women (ZDVf: -2.03 g/dl; ZDVs: -1.36 g/dl, p = 0.036). A similar trend was observed for occurrence of maternal anaemia at 36 weeks. Newborns with no prenatal ZDV exposure had significantly higher haemoglobin levels at birth (ZDVf: 16.1 ± 1.4 g/dl, ZDVs: 14.3 ± 2.0 g/dl; ZDVc: 14.6 ± 2.4 g/dl, p = 0.044 and 0.003, respectively). Conclusions: Half of ZDV-unexposed mothers had anaemia at the end of pregnancy, but their neonates had normal haemoglobin levels. ZDV initiation was associated with a lower occurrence of maternal anaemia during the third trimester and decreased haemoglobin levels in the newborns. We hypothesize that foetal iron requirements could represent a major determinant of maternal anaemia at the end of pregnancy.",
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AU - Ricerca, Bianca Maria

AU - Cavaliere, Anna Franca

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