Letters Section Editor: Stephen J. Lurie,
MD, PhD, Senior Editor.
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.
Frieden IJ, Haggstrom AN, McCulloch C, Drolet B, Esterly NB, Garzon MC, Lucky AW, Baselga E, Friedlander SF. Combined Antiretroviral Therapy During Pregnancy and Risk of Congenital Malformations. JAMA. 2004;291(16):1961-1962. doi:10.1001/jama.291.16.1961-b