Effect of maternal use of antiretroviral agents on serum insulin levels of the newborn infant.
OBJECTIVE
The aim of this study was to investigate the effect of antiretroviral drugs on neonatal serum insulin levels.


METHODS
A prospective study was conducted on 57 pregnant women divided into three groups: the zidovudine (ZDV) group, HIV-infected women taking ZDV (n = 20); the triple treatment group, HIV-infected women taking triple antiretroviral agents ZDV + lamivudine + nelfinavir (n = 25); and the control group, pregnant women considered normal from a clinical and laboratory standpoint (n = 12). Blood was collected from the umbilical cord of newborn infants upon delivery for measurement of insulin level. The insulin measurements were performed in duplicate by radioimmunoassay.


RESULTS
Demographic and anthropometric data were homogeneous, and pregnant women with a personal and family history of diabetes were excluded. There was no difference between groups regarding glycemia in the newborn. Median newborn insulin doses were 2.9, 4.8, and 6.5 muU/ml for the triple treatment, ZDV, and control groups, respectively (P < 0.05).


CONCLUSIONS
Use of triple therapy during pregnancy induced a significant decrease in serum levels of neonatal insulin compared with the control group. Active surveillance of short- and long-term adverse events is imperative to issue a definitive statement regarding the impact that use of protease inhibitors during pregnancy will have on infant metabolism.
El Beitune
Patrícia
P
Department of Obstetrics and Gynecology, School of Medicine of Ribeirão Preto/USP, University of São Paulo-Ribeirão Preto, São Paulo 14049-900, Brazil. pbeitune@ig.com.br
Duarte
Geraldo
G
Foss
Milton C
MC
Montenegro
Renan M
RM
Quintana
Silvana M
SM
Figueiró-Filho
Ernesto A
EA
Nogueira
Antonio A
AA
D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D001786:Blood Glucose / Q000032:analysis; D015331:Cohort Studies; D005260:Female; D005312:Fetal Blood / Q000737:chemistry; D006801:Humans; D007231:Infant, Newborn / Q000097:blood*; D007328:Insulin / Q000097:blood*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy*; D011297:Prenatal Exposure Delayed Effects; D015215:Zidovudine / Q000627:therapeutic use*
D019380:Anti-HIV Agents; D001786:Blood Glucose; D007328:Insulin; D015215:Zidovudine