Ramokolo, VundliGoga, Ameena EbrahimLombard, CarlDoherty, TanyaJackson, Debra J.Engebretsen, Ingunn M.S.2018-03-152018-03-152017Ramokolo, V., Goga, A.E., Lombard, C. et al. 2017, 'In utero ART exposure and birth and early growth outcomes among HIV-exposed uninfected infants attending immunization services : results from National PMTCT Surveillance, South Africa ', Open Forum Infectious Diseases, vol. 4, no. 4, pp. 1-10.2328-8957 (online)10.1093/ofid/ofx187http://hdl.handle.net/2263/64289We would like to thank the mothers/caregivers and infants who participated in the 2012–13 South African PMTCT Evaluation survey.The work was presented in part at the 6th African Nutritional Epidemiology Conference; July, 21–25, 2014; Accra, Ghana and the 9th International AIDS Conference on HIV Science; July, 23–26, 2017; Paris, France.BACKGROUND. Despite the recognized benefit of antiretroviral therapy (ART) for preventing and treating HIV, some studies have reported adverse birth outcomes with in utero ART exposure. We evaluated the effect of infant in utero HIV and ART exposure on preterm delivery (PTD), low birth weight (LBW), small for gestational age (SGA), and underweight for age (UFA) at 6 weeks. METHODS. We surveyed 6179 HIV-unexposed-uninfected (HUU) and 2599 HIV-exposed-uninfected (HEU) infants. HEU infants were stratified into 3 groups: ART, Zidovudine alone, and no antiretrovirals (None). The ART group was further stratified to explore pre- or postconception exposure. Multivariable logistic regression evaluated effects of HIV and ARV exposure on the outcomes. RESULTS. We found higher odds of PTD, LBW, SGA, and UFA in HEU than HUU infants. HEU in the None group (adjusted odds ratio [AOR], 1.9; 95% confidence interval [CI], 1.2–3.0) or those whose mothers initiated ART preconception (AOR, 1.7; 95% CI, 1.1–2.5) had almost twice the odds of PTD than infants whose mothers started ART postconception, but no increased odds for other outcomes. CONCLUSIONS. There was an association between preconception ART and PTD. As ART access increases, pregnancy registers or similar surveillance should be in place to monitor outcomes to inform future policy.enThe Author(s) 2017. Published by Oxford University Press on behalf of Infectious Diseases Society of America. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/ by-nc-nd/4.0/).Birth outcomeAntiretroviral therapy (ART)Human immunodeficiency virus (HIV)South Africa (SA)Underweight for age (UFA)Small for gestational age (SGA)Low birth weight (LBW)Preterm delivery (PTD)Mother-to child transmission (MTCT)Article