Pregnant women who took antiretroviral medication for HIV may have children with a higher risk for developmental delays at age of 5, new research has found.
The findings of the new Pediatric HIV/AIDS Cohort study highlighted the need to monitor the neurodevelopment of children whose mothers took antiretrovirals during pregnancy.
However, the researchers affirmed that it is still important for women with HIV to take antiretroviral therapy during pregnancy to prevent transmission of the disease to their fetuses.
HIV Treatment During Pregnancy
A woman who has HIV can pass the infection to the baby during pregnancy, through labor, delivery and even breastfeeding.
HIV treatment during pregnancy aims to protect the health of the mother and prevent perinatal transmission to the fetus.
Anti-HIV drugs decrease the amount of the virus in the body. Antiretroviral therapy protected around 15.4 million children under 15 who were exposed to HIV in the womb in 2020.
The medics recommend pregnant women with HIV to take antiretrovirals as soon as possible during their pregnancy. In addition, those women who are already on an effective HIV treatment regimen are suggested to continue the treatment throughout their pregnancy.
The doctors also recommend cesarean delivery for those women who have high or unknown viral loads near the time of delivery.
Antiretrovirals And Developmental Delays
Although successful in preventing perinatal transmission of HIV, early research suggested that antiretrovirals may increase the odds of delays in language, cognitive skills and behavioral challenges among children. However, it was unclear in those studies if the medications caused the delays or if it was due to other factors such as poor parental health, substance use or insufficient nutrition and oxygen.
Researchers also noticed that most studies only evaluated individual areas of neurodevelopment. As a result, the latest research was focused on the potential effects of the therapy on three factors of development, including language, emotional-behavioral development and cognition.
Among 230 children whose mothers received drug treatment for HIV during pregnancy, 15% had lower scores in one area of development and 8% faced difficulties in at least two of the three areas of development.
For those 461 children whose mothers began antiretrovirals during pregnancy, 21% had a delay in one area of development, while 12% suffered delays in at least two of the three developmental areas, the study found.
The researchers also compared the effects of drug regimens with atazanavir to drug combinations without it. They found that those on atazanavir were at 70% higher risk of facing developmental delays in children.
Researchers still recommend the use of antiretrovirals while suggesting the need for monitoring the neurodevelopment in children whose mothers used them during pregnancy.