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

Research output: Contribution to journalArticle

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

Keywords

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

ASJC Scopus subject areas

  • Infectious Diseases
  • Microbiology (medical)

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  • Cite this

    Pinnetti, C., Baroncelli, S., Molinari, A., Nardini, G., Genovese, O., Ricerca, B. M., Cavaliere, A. F., Guaraldi, G., Antoni, A. D., Tamburrini, E., & 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