ZIDOVUDINE USE IN PREGNANCY - A REPORT ON 104 CASES AND THE OCCURRENCE OF BIRTH-DEFECTS

As more women of childbearing age are being identified as HIV infected , vertical transmission to the fetus and/or neonate is an increasingly significant therapeutic problem. Currently the use of zidovudine is o ne of the few specific measures available, and as a potentially terato genic and fetotoxic agent, any decision for its use requires evaluatio n of the potential for fetal damage. In a series of 104 cases of inten tional or inadvertent use of zidovudine at differing gestations in pre gnancy, there were eight spontaneous first trimester abortions, eight therapeutic terminations, and eight cases of fetal abnormality occurri ng among a total of 88 cases where the pregnancy progressed. Analysis and correlation of antenatal data and drug therapy with individual cas es failed to show any specific abnormality that could reasonably be at tributed to zidovudine therapy. While not proving safety, these data a dd to previous smaller series with similar findings, thus lending tenu ous support to the use of this agent. Continuing studies are required, particularly to clarify the possibility of long-term developmental de fects.