Safety of tenofovir use during pregnancy: Early growth outcomes in HIV-exposed uninfected infants

George K. Siberry, Paige L. Williams, Hermann Mendez, George R. Seage, Denise L. Jacobson, Rohan Hazra, Kenneth C. Rich, Raymond Griner, Katherine Tassiopoulos, Deborah Kacanek, Lynne M. Mofenson, Tracie Miller, Linda A. Dimeglio, D. Heather Watts

Research output: Contribution to journalArticlepeer-review

108 Scopus citations


Objective: To evaluate the association of tenofovir disoproxil fumarate (TDF) use during pregnancy with early growth parameters in HIV-exposed, uninfected (HEU) infants. Design: US-based prospective cohort study of HEU children to examine potential adverse effects of prenatal TDF exposure. Methods: We evaluated the association of maternal TDF use during pregnancy with small for gestational age (SGA); low birth weight (LBW, <2.5 kg); weight-for-age z-scores (WAZ), length-for-age z-scores (LAZ), and head circumference-for-age (HCAZ) z-scores at newborn visit; and LAZ, HCAZ, and WAZ at age 1 year. Logistic regression models for LBW and SGA were fit, adjusting for maternal and sociodemographic factors. Adjusted linear regression models were used to evaluate LAZ, WAZ, and HCAZ by TDF exposure. Results: Of 2029 enrolled children with maternal antiretroviral information, TDF was used by 449 (21%) HIV-infected mothers, increasing from 14% in 2003 to 43% in 2010. There was no difference between those exposed to combination regimens with vs. without TDF for SGA, LBW, and newborn LAZ and HCAZ. However, at age 1 year, infants exposed to combination regimens with TDF had significantly lower adjusted mean LAZ and HCAZ than those without TDF (LAZ:-0.17 vs.-0.03, P = 0.04; HCAZ: 0.17 vs. 0.42, P = 0.02). Conclusion: TDF use during pregnancy was not associated with increased risk for LBW or SGA. The slightly lower mean LAZ and HCAZ observed at age 1 year in TDF-exposed infants are of uncertain significance but underscore the need for additional studies of growth outcomes after TDF use during pregnancy.

Original languageEnglish (US)
Pages (from-to)1151-1159
Number of pages9
Issue number9
StatePublished - Jun 1 2012
Externally publishedYes


  • antiretroviral drugs
  • infant growth
  • perinatal HIV exposure
  • pregnancy
  • tenofovir disoproxil fumarate

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases


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