Prospective mothers with HIV are recommended to take antiretroviral therapy during pregnancy to prevent HIV transmission to the baby. However, a recent study has found that HIV-free children whose mothers took antiretroviral medication during pregnancy may be at a higher risk for developmental delays, especially in language, emotional-behavioral development, and cognition. The study highlights the need to periodically assess children exposed to antiretroviral therapy in the womb so that delays can be identified early when opportunities for support and intervention are greatest. The study found that children whose mothers began treatment during pregnancy had a higher risk of developmental delay, and those whose mothers’ regimens included the drug atazanavir had a 70% greater chance of having one or more developmental lags. However, researchers did not observe this increased risk associated with atazanavir among children whose mothers were already on antiretroviral therapy when they became pregnant. The authors underscored the importance of monitoring the neurodevelopment of children whose mothers took antiretroviral medication during pregnancy, and of more research on the timing of children’s exposure to antiretroviral treatments during pregnancy.
Children who are free from HIV and whose mothers started taking antiretroviral medication during pregnancy may be at an increased risk for developmental delays, according to a study supported by the National Institutes of Health. This risk is higher for children whose mothers began treatment while pregnant, particularly if the regimen contained the drug atazanavir. The findings highlight the importance of monitoring the neurodevelopment of children whose mothers took antiretroviral medication during pregnancy.
The Study
The study was conducted by Tzy-Jyun Yao, Ph.D., and colleagues in the Pediatric HIV/AIDS Cohort Study, which receives funding from various NIH institutes, including the National Institute of Child Health and Human Development. The study appears in the journal AIDS Patient Care and STDs.
Background
Antiretroviral therapy has been successful in reducing the number of children born with HIV. However, it is known that these drugs can cross the placenta and there are concerns that their use during pregnancy could increase the risk of neurodevelopmental effects, such as language and cognitive delays and behavioral challenges.
Conclusion
The authors of the study are calling for more research on the timing of children’s exposure to antiretroviral treatments during pregnancy. The findings of this study underscore the need for careful monitoring of the neurodevelopment of children who do not have HIV but whose mothers took antiretroviral medication during pregnancy.
A recent study supported by the National Institutes of Health has found that HIV-free children whose mothers took antiretroviral medication during pregnancy may be at a higher risk for developmental delays. The authors added that the developing fetal brain is susceptible to a variety of environmental influences. However, it is often difficult to determine whether developmental delay in children without HIV whose mothers were treated with antiretroviral therapy during pregnancy is due to the therapy or other factors.
The Study
The study evaluated potential effects of antiretroviral therapy on three developmental domains: language, emotional-behavioral development, and cognition. Researchers compared exposure to regimens with atazanavir, a drug linked to language and social and emotional delays, to combinations that did not include atazanavir. They also looked at whether these effects were different for children whose mothers were receiving antiretroviral therapy before they got pregnant, compared to those whose mothers began treatment after they got pregnant.
Results
Of the children whose mothers began treatment during pregnancy, 21% had a delay in one developmental domain and 12% had delays in at least two of the three developmental domains. Those whose mothers’ regimens included atazanavir had a 70% greater chance of having one or more developmental lags. However, researchers did not observe this increased risk associated with atazanavir among children whose mothers were already on antiretroviral therapy when they became pregnant.
Significance
The authors said that their study is the first to identify the potential risk across multiple neurodevelopmental domains among HIV-free children born to mothers receiving antiretroviral treatment during pregnancy. The study detected increased developmental risk at five years, a critical age when young children often initiate formal schooling.
Prospective mothers with HIV are urged to take antiretroviral therapy during pregnancy to prevent HIV transmission to the baby. However, a recent study emphasized the need to periodically assess children exposed to antiretroviral therapy in the womb so that delays can be identified early when opportunities for support and intervention are greatest. The authors added that it is especially important for people living with HIV who are aware of their HIV status and could become pregnant to be on antiretroviral therapy to help protect the health of the fetus in case they do become pregnant. The study, published in the journal AIDS Patient Care and STDs, focused on the risk of neurodevelopmental problems in HIV-exposed uninfected 5-year-old children.
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