title: The Use of Protease Inhibitors in Pregnancy: Maternal and Fetal Considerations.
abstract: BACKGROUND
  Previous studies examining protease inhibitor use in pregnancy and the rate of preterm and small-for-gestational-age infants have yielded conflicting results.
  
  
  METHODS
  This was a retrospective study of HIV-infected women who delivered singleton infants at our institution between 1984 and 2014. Women with protease inhibitor use were compared to women on regimens without a protease inhibitor as well as those who received no antepartum antiretroviral therapy. Infants were considered preterm if less than 37 completed weeks of gestation and small-for-gestational-age if less than 10th percentile.
  
  
  RESULTS
  During the study period 1,004 pregnancies met inclusion criteria. Of those, 597 received a protease inhibitor as part of their regimen, 230 ART without a protease inhibitor, and 177 no ART. There was no difference in the rate of preterm birth between groups who received ART with or without a protease inhibitor, 14% versus 13%. There was no difference in the rate of small-for-gestational-age infants between the three groups. Use of a protease inhibitor was associated with a greater fall in viral load during pregnancy, p < 0.001.
  
  
  CONCLUSIONS
  In this population with access to prenatal care and ART, treatment with protease inhibitors was associated with a greater fall in viral load, but not an increase in small or preterm infants.
authors.affiliation: Department of Obstetrics and Gynecology, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA.
authors.forename: Elaine
authors.initials: E
authors.lastname: Duryea
authors.affiliation: Department of Obstetrics and Gynecology, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA.
authors.forename: Fiona
authors.initials: F
authors.lastname: Nicholson
authors.affiliation: Department of Obstetrics and Gynecology, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA.
authors.forename: Sara
authors.initials: S
authors.lastname: Cooper
authors.affiliation: Department of Obstetrics and Gynecology, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA.
authors.forename: Scott
authors.initials: S
authors.lastname: Roberts
authors.affiliation: Department of Obstetrics and Gynecology, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Rogers
authors.affiliation: Department of Obstetrics and Gynecology, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA.
authors.forename: Donald
authors.initials: D
authors.lastname: McIntire
authors.affiliation: Department of Obstetrics and Gynecology, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA.
authors.forename: Jeanne
authors.initials: J
authors.lastname: Sheffield
authors.affiliation: Department of Obstetrics and Gynecology, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Stewart
mesh_terms: D000293:Adolescent; D000328:Adult; D001724:Birth Weight / Q000187:drug effects; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology; D017320:HIV Protease Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D007234:Infant, Premature; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy* / Q000453:epidemiology; D011480:Protease Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D012189:Retrospective Studies; D019562:Viral Load / Q000187:drug effects; D055815:Young Adult
chemical_list: D017320:HIV Protease Inhibitors; D011480:Protease Inhibitors