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HAART Use Prior to Pregnancy Associated with Pre-Eclampsia

Insulin resistance, endothelial inflammation may be underlying mechanism

WEDNESDAY, Dec. 21 (HealthDay News) -- Women infected with HIV who receive highly active antiretroviral therapy (HAART) before becoming pregnant have a higher risk of pre-eclampsia and fetal death than other women, Spanish researchers report in the January issue of AIDS.

Anna Suy, M.D., and colleagues at the University of Barcelona, analyzed a database of 8,768 pregnant women from November 1985 to January 2003, which included 472 HIV-infected patients. Between January 2001 and July 2003, there were 82 HIV-infected patients, 244 cases of pre-eclampsia without fetal death, 39 cases of fetal death without pre-eclampsia and seven cases of fetal death and pre-eclampsia referred.

In all women, the odds of pre-eclampsia or fetal death was 3.6 with multiple gestation and 4.9 with HIV infection. In HIV-infected women, use of HAART prior to pregnancy was an independent risk factor (odds ratio, 5.6) for pre-eclampsia and fetal death.

The researchers conducted a case-control substudy and found that insulin resistance and endothelial inflammation may be potential underlying mechanisms linking pre-pregnancy HAART exposure and pre-eclampsia and fetal death. "If our results are confirmed, close monitoring for pre-eclampsia and fetal distress in HIV-infected pregnant women will be needed," they conclude.

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