Prenatal zidovudine use and congenital anomalies in a medicaid population.
OBJECTIVE
To examine the association of prescribed zidovudine (ZDV) during pregnancy with congenital anomalies in a population-based cohort.


METHODS
Medicaid claims were used to assess prescribed ZDV and children's major congenital anomalies in 1932 liveborn deliveries from 1993 to 1996 to HIV-infected women in the state of New York (NYS), U.S.A. Prevalence of anomalies in the cohort was compared with that of a general NYS population. Within the cohort, adjusted odds of any anomaly were compared by receipt of ZDV and by trimester of first prescription.


RESULTS
The adjusted prevalence of any anomaly in the study cohort was 2.76 times greater than in the general population (95% confidence interval [CI], 2.36-3. 17). Children of study women who were prescribed ZDV had increased adjusted odds of any anomaly (adjusted odds ratio [OR], 1.55; 95% CI, 1.01-2.29). Adjusted ORs (with CIs) by trimester of first prescription were 1.20 (0.58-2.51), 1.47 (0.85-2.55), and 1.84 (1. 04-3.25) for the first, second, and third trimesters, respectively.


CONCLUSIONS
Children of HIV-infected women in this cohort had a greater prevalence of major anomalies than did the general NYS population. An increased risk of major anomalies was not evident for first trimester exposure when the association would have been most biologically plausible.
Newschaffer
C J
CJ
Department of Epidemiology, Johns Hopkins School of Hygiene and Public Health, Baltimore, Maryland 21205, USA.
Cocroft
J
J
Anderson
C E
CE
Hauck
W W
WW
Turner
B J
BJ
D000014:Abnormalities, Drug-Induced / Q000453:epidemiology*; D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects*; D018376:Cardiovascular Abnormalities / Q000139:chemically induced; D002490:Central Nervous System / Q000002:abnormalities; D004065:Digestive System Abnormalities; D005260:Female; D015658:HIV Infections / Q000188:drug therapy; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008484:Medicaid; D009139:Musculoskeletal Abnormalities / Q000139:chemically induced; D009518:New York / Q000453:epidemiology; D009519:New York City / Q000453:epidemiology; D010298:Parity; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D015995:Prevalence; D012042:Registries; D012189:Retrospective Studies; D014481:United States; D015215:Zidovudine / Q000009:adverse effects*
D019380:Anti-HIV Agents; D015215:Zidovudine