title: Common occurrence of anaemia at the end of pregnancy following exposure to zidovudine-free regimens.
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.
authors.affiliation: Department of Infectious Diseases, Catholic University, Rome, Italy.
authors.forename: Carmela
authors.initials: C
authors.lastname: Pinnetti
authors.forename: Silvia
authors.initials: S
authors.lastname: Baroncelli
authors.forename: Atim
authors.initials: A
authors.lastname: Molinari
authors.forename: Giulia
authors.initials: G
authors.lastname: Nardini
authors.forename: Orazio
authors.initials: O
authors.lastname: Genovese
authors.forename: Bianca Maria
authors.initials: BM
authors.lastname: Ricerca
authors.forename: Anna Franca
authors.initials: AF
authors.lastname: Cavaliere
authors.forename: Giovanni
authors.initials: G
authors.lastname: Guaraldi
authors.forename: Anna Degli
authors.initials: AD
authors.lastname: Antoni
authors.forename: Enrica
authors.initials: E
authors.lastname: Tamburrini
authors.forename: Marco
authors.initials: M
authors.lastname: Floridia
mesh_terms: D000328:Adult; D000740:Anemia / Q000175:diagnosis*; D019380:Anti-HIV Agents / Q000008:administration & dosage*; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods*; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy*; D015215:Zidovudine / Q000008:administration & dosage
chemical_list: D019380:Anti-HIV Agents; D015215:Zidovudine