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Effect of Maternal Use of Antiretroviral Agents on Serum Insulin Levels of the Newborn Infant
- El Beitune, Patrícia, Duarte, Geraldo, Foss, Milton C., Montenegro, Renan M., Quintana, Silvana M., Figueiró-Filho, Ernesto A., Nogueira, Antonio A.
- Diabetes care 2005 v.28 no.4 pp. 856-859
- blood glucose, blood serum, diabetes, drugs, insulin, metabolism, monitoring, neonates, pregnancy, pregnant women, prospective studies, proteinase inhibitors, radioimmunoassays, therapeutics, umbilical cord
- OBJECTIVE:--The aim of this study was to investigate the effect of antiretroviral drugs on neonatal serum insulin levels. RESEARCH DESIGN AND METHODS--A prospective study was conducted on 57 pregnant women divided into three groups: the zidovudine (ZDV) group, HIV-infected women taking ZDV (n = 20); the triple treatment group, HIV-infected women taking triple antiretroviral agents ZDV + lamivudine + nelfinavir (n = 25); and the control group, pregnant women considered normal from a clinical and laboratory standpoint (n = 12). Blood was collected from the umbilical cord of newborn infants upon delivery for measurement of insulin level. The insulin measurements were performed in duplicate by radioimmunoassay. RESULTS:--Demographic and anthropometric data were homogeneous, and pregnant women with a personal and family history of diabetes were excluded. There was no difference between groups regarding glycemia in the newborn. Median newborn insulin doses were 2.9, 4.8, and 6.5 [micro]U/ml for the triple treatment, ZDV, and control groups, respectively (P < 0.05). CONCLUSIONS:--Use of triple therapy during pregnancy induced a significant decrease in serum levels of neonatal insulin compared with the control group. Active surveillance of short- and long-term adverse events is imperative to issue a definitive statement regarding the impact that use of protease inhibitors during pregnancy will have on infant metabolism.