Antiretroviral Therapy and Pregnancy Outcomes in Developing Countries: A Systematic Review
نویسندگان
چکیده
BACKGROUND Despite significant efforts to understand adverse pregnancy outcome in women receiving Antiretroviral Therapy (ART), ART-related adverse birth outcomes are still poorly understood. We systematically review ART-related adverse birth outcomes among HIV-infected pregnant women; we also review the covariates associated with adverse birth outcomes in the aforementioned group. METHODS The main source for our systematic review was electronic bibliographic databases. Databases such as MEDLINE, PubMed, EMBASE and AIDSLINE were searched. Furthermore, search engines such as Google and Google Scholar were specifically searched for gray literature. Methodological quality of available literature was assessed using the Newcastle - Ottawa Quality Assessment Scale & M. Hewitt guideline. We examined a total of 1,124 papers and reviewed the studies using the PICOT criteria which stands for Patient (population), Intervention (or "Exposure"), Comparison, Outcome and Type of study. Finally, 32 methodologically fit studies were retained and included in our review. RESULTS Frequently observed adverse birth outcomes included low birth weight (LBW), Preterm Birth (PB), Small for Gestational Age (SGA), while still birth and congenital anomalies were infrequent. Type of regimen such as Protease Inhibitor (PI) based regimens and timing of initiation of ART are some of the factors associated with adverse pregnancy outcomes. Covariates principally included malnutrition and other co-morbidities such as malaria and HIV. CONCLUSIONS AND PUBLIC HEALTH IMPLICATIONS There is growing evidence in published literature suggesting that ART might be causing adverse birth outcomes among pregnant women in developing countries. There is a need to consider regimen types for HIV-infected pregnant women. There is need to design large cohort studies.
منابع مشابه
Non-clinical outcomes of antiretroviral therapy for HIV/AIDS in developing countries: a systematic literature review
متن کامل
Exposure to Air Pollution and Pregnancy Outcomes in the East Mediterranean Region: a Systematic Review
The East Mediterranean region suffers from high levels of air pollution which has a negative impact on pregnancy outcomes. This work systematically reviews the epidemiological evidence on maternal exposure to air pollution and adverse pregnancy outcomes in the region. Relevant papers and reports published between 2000 and 2014 were searched. Combinations of search terms including countries, exp...
متن کاملThe prevalence of iron deficiency anemia during pregnancy in Iran (1991-2015): A systematic review and meta-analysis
Background and aims: The prevalence of iron deficiency anemia (IDA) in pregnant women is in Variable between 40-80% in developing countries. There are some differences among different studies on this disorder. So, this present study is been performed for evaluating the prevalence of IDA among pregnant Iranians with systematic review and meta-analysis method. Methods: This study is based on rec...
متن کاملMaternal Anemia and Pregnancy outcomes: a Systematic Review and Meta-Analysis
Background The aim of this study was to determine the relationship between maternal anemia during pregnancy and pregnancy outcomes. Materials and Methods This systematic review was conducted in domestic (Sid, Iran.doc, Iran medex and Magiran) and international (PubMed, Science Direct, Cochrane, Medline, Web of Science, Scopus, Springer, Embase, Google scholar) databases from January 1, 1990 t...
متن کاملSafety of efavirenz in the first trimester of pregnancy: an updated systematic review and meta-analysis.
INTRODUCTION Primate studies and some observational human data have raised concern regarding an association of first-trimester efavirenz exposure with central nervous system congenital anomalies. The objective of this review is to update evidence on efavirenz safety in HIV-infected pregnant women to inform revision of the 2013 WHO guidelines for antiretroviral therapy in low and middle-income c...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
دوره 3 شماره
صفحات -
تاریخ انتشار 2015