1. Background Since 1996, HAART progressively replaced ZDV monotherapy to prevent mother-to- child HIV transmission  Is HAART associated with low birthweight independently on gestational age? Methods Study population All uninfected neonates born to HIV-infected mothers enrolled in the ANRS French Perinatal Cohort (EPF) : 1994-2006 – n=6538 Excepted: untreated mothers, late booking (> 28 wks gestation), drug users, twin pregnancies Anthropometric parameters Birthweight Z-scores, adjusted for gestational age at delivery and sex (French standards : Audipog) Lack of association between birthweight and prepartum HAART administered to mothers of HIV-uninfected neonates N. Briand, J. Le Chenadec, S. Blanche, J.-P. Teglas, C. Dollfus, A. Faye, C. Rouzioux, R. Tubiana, J. Warszawski, L. Mandelbrot, ANRS French Perinatal Cohort

2. Evolution of birthweight for each gestational age at birth 41 40 39 38 37 36 35 34 33 <32 Gestational weeks Treatment evolution 1994-19951997-19981999-20042005-2006 Monotherapy 99% 18%19%2% Bitherapy1% 65% 21%5% Multitherapy17% 60%93% 2006

3. Association between multitherapy and birthweight linear regression Median Z-scores Multivariate analysis ARV Mean diff. (95% CI)P 1994-95: Monotherapy-0.19Ref 1997-98: Bitherapy-0.22 0.02 (-0.14;0.17) 1999-2004: Mono exclusively0.07 0.16 (0.02;0.29) Bitherapy0.00 0.10 (-0.03;0.23) Haart/Mono/Dual0.01 0.14 (-0.03;0.31) Haart exclusively-0.10 0.001 (-0.11;0.12) 2005-06: Haart exclusively-0.15 -0.08 (-0.21;0.05) Global test (p) 0.0002 Adjustment for time at first antenatal visit, sub-Saharan African origin, maternal age, parity and CD4 cell count When taking into account gestational age at birth, neonates exposed to exclusive HAART in 2005-2006 did not have lower birthweight, compared to neonates exposed to monotherapy in the reference period 1994-1995