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April 28, 2004

Combined Antiretroviral Therapy During Pregnancy and Risk of Congenital Malformations

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2004;291(16):1961-1962. doi:10.1001/jama.291.16.1961-b

To the Editor: In their Research Letter, Dr De Santis and colleagues1 reported a possible association of infantile hemangiomas with combined antiretroviral therapy (CART) during pregnancy. As a control group, the authors identified all pregnancies in which the mother had contacted a teratology information service. There are numerous ways, however, in which these groups are not comparable, and which may thus confound the observed association. First, the control group was self-selected. Second, infantile hemangiomas are very common. Although their precise incidence is not known, estimates range from 4% to 10%.2 In addition, the increased frequency found in female and premature infants3 could easily have confounded the increase in the group treated with CART.

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