Pregnancy-related changes in the longer-term management of HIV-infected women in Europe.

OBJECTIVES To clarify policies regarding management of HIV-infected women, relating to pregnancy, in view of current European consensus guidelines. STUDY DESIGN Postal questionnaire survey in 36 hospitals in 11 European countries. RESULTS Responses were received from 22 (61%) centres, representing all 11 countries. In principle, antiretroviral therapy (ART) would be reviewed in treated women wanting to become pregnant in nearly all centres. Multidisciplinary management of infected pregnant women was routine in 17 (77%) centres, facilitating continuity of care. Approximately half the clinicians would use zidovudine monotherapy for pregnant women without indications for ART, while the remainder prescribed combination therapy. In 1998-2000, pre-eclampsia was the most prominent adverse event (22 centres) in women receiving ART, with congenital abnormalities (13 abnormalities in 6 centres) and stillbirth (5 centres) also reported. CONCLUSIONS Policies varied, particularly regarding prophylactic ART for women without indications for treatment and did not always follow current European guidelines.