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 I I European countries. Results: Responses were received from 22 (61%) centres, representing all I I 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.