Weigh Fetal Exposure Risks Against Undertreatment

On the safety of ART, pregnancy outcome studies do not suggest an increase in spontaneous abortion, stillbirth, LBW, or low Apgar scores in association with these medications—and so there is no need to stop these drugs, she said. In fact, if any medication needs to be stopped because of hyperemesis, she recommends all medications be eliminated together to avoid the risk of developing resistance.

The only exception to this is efavirenz (Sustiva, Bristol-Myers Squibb), which is the only HIV medication now classified as category D because it has been linked to an increase in neural tube defects, she said. This drug should ideally be stopped before conception.