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Is protease inhibitors based antiretroviral therapy during pregnancy associated with an increased risk of preterm birth? Systematic review and a meta-analysis

Overview of attention for article published in Reproductive Health, April 2016
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Title
Is protease inhibitors based antiretroviral therapy during pregnancy associated with an increased risk of preterm birth? Systematic review and a meta-analysis
Published in
Reproductive Health, April 2016
DOI 10.1186/s12978-016-0149-5
Pubmed ID
Authors

Yonatan Moges Mesfin, Kelemu Tilahun Kibret, Amsalu Taye

Abstract

Antiretroviral therapy is recommended during pregnancy to decrease the risk of perinatal transmission of HIV-1 infection and to improve maternal health. However, some studies have reported that antiretroviral treatment (ART) containing protease inhibitors (PI) is associated with an increased risk of preterm birth. In contrast, other studies have reported no increased risk. This meta-analysis was conducted to derive a more reliable estimate of the association between the prenatal use of PI based ART regimen and preterm birth. A systemic review and meta-analysis was conducted using published studies which were identified through a computerized search using the Medline/PubMed database, Google Scholar and Health Inter Network Access to Research Initiative (HINARI). The analysis was undertaken using STATA version 11.0 software and studies were described by forest plot. Heterogeneity across studies was checked using Cochran Q test and I(2) test. An adjusted odd ratio with 95 % confidence intervals [95 % CI] was pooled using a random effects model. The Cochrane Q test (Q test p = 0.051) showed a good homogeneity among studies. However, medium heterogeneity was observed in up to 46 % of the sample using the I(2) test (I(2) = 46.5 %). The Egger weighted regression method (p = 0.04) showed evidence of publication bias, but Begg rank correlation statistics (p = 0.47) did not show evidence of publication bias. The pooled analysis of 10 studies showed that protease based ART exposure during pregnancy was associated with an increased risk of preterm birth (pooled odds ratio 1.32 (95 % CI, 1.04 to 1.59). This meta-analysis revealed that the PI based ART exposure during pregnancy is significantly associated with an increased risk of preterm birth. There should be strong cautions against initiating ART during pregnancy and PI based ARV should be replaced by others drug regime. Protease inhibitor ART drugs should not be included as part of therapy during pregnancy.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 100 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 100 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 17 17%
Student > Ph. D. Student 15 15%
Student > Master 11 11%
Student > Bachelor 11 11%
Student > Doctoral Student 7 7%
Other 16 16%
Unknown 23 23%
Readers by discipline Count As %
Medicine and Dentistry 40 40%
Nursing and Health Professions 9 9%
Immunology and Microbiology 5 5%
Agricultural and Biological Sciences 3 3%
Biochemistry, Genetics and Molecular Biology 3 3%
Other 13 13%
Unknown 27 27%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 02 February 2024.
All research outputs
#20,941,352
of 23,572,509 outputs
Outputs from Reproductive Health
#1,352
of 1,447 outputs
Outputs of similar age
#256,701
of 302,131 outputs
Outputs of similar age from Reproductive Health
#21
of 21 outputs
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We're also able to compare this research output to 21 others from the same source and published within six weeks on either side of this one. This one is in the 1st percentile – i.e., 1% of its contemporaries scored the same or lower than it.