"We do not have enough information about the effects of many medications when they are taken by pregnant women. The U.S. Food and Drug Administration (FDA) regulates medications to ensure their general safety and effectiveness. All prescription and over-the-counter medications are tested to see if they are safe and effective before they become available to the public. Pregnant women usually are not included in these tests because of the possible risks to the unborn baby. As a result, little information is available about the safety of most medications during pregnancy--including those available over the counter--when they first become available."
CDC on "Medications and Pregnancy"
It was and still is standard practice to discourage pregnant women from ingesting any drugs unless it is a medical necessity. This is because of the concern about serious birth defects. I grew up hearing about the tragedies of the mothers who took Thalamid for morning sickness and had deformed infants. During my pregnancies in the eighties, I took no meds-prescription or non-prescription, no illegal substances, no alcohol (was ridiculed by some friends for not having just one drink) because I was concerned about birth defects. Maybe I went to extremes, but I really don't think so. It seems from the above CDC statement, we are in the dark about the effects of most drugs on the pregnant mother and her unborn child. So we don't know about the risks, unless pregnant mothers take the meds and give birth to infants with problems.
How does this impact pregnant women who are diagnosed with hiv in their pregnancy? (a second pregnancy and subsequent pregnancies can create a false positive hiv test) Obviously, the risk of birth defects is outweighed by the risk of transmission. Yet there are studies that should have us concerned about the use of very toxic drugs in pregnancy and its impact on infants. A study was reported in 2007 that stated "that AZT caused genetic damage to infants which may increase their risk of developing cancer in the future.."
Walker DM et al. Transplacental carcinogenicity of 3'Azido-3'Deoxythymidine in B6C3F1 mice and F344 rats. Environmental and Molecular Mutagenesis 48:283-298, 2007.
What about drug safety for newborns diagnosed with hiv (testing in the newborn period is unreliable according to a Baylor College Nursing textbook on hiv/aids)? For instance a recent safety announcement by the FDA about Kaletra oral solution used in premature babies (used in hiv treatment and the oral solution contains alcohol and propylene glycol) and newborns under 14 days states, "Because the consequences of using Kaletra oral solution in babies immediately after birth can be severe or possibly fatal, the label is being revised to include a new warning."
Of interest to readers might be this document entitled "Recommendations for Use of Antiretroviral Drugs in Pregnant HIV-1-Infected Women for Maternal Health and Interventions to Reduce Perinatal HIV Transmission in the United States." revised 9/14/11 page 1 of over 200 page document
"The benefits of ARV drugs for a pregnant women must be weighted against the risks of adverse events to the woman, fetus, and newborn. Combination drug regimens are considered the standard of care both for treatment of HIV infection and for prevention of perinatal transmission of HIV. After provider counseling and discussion on ARV drug use during pregnancy, a pregnant women's informed choice on whether to take ARV drugs either for her treatment or for prevention of mother-to-child transmission or to follow other medical recommendations intended to reduce perinatal transmission of HIV should be respected. Coercive and punitive policies are potentially counterproductive,they may undermine provider-patient trust and could discourage women from seeking prenatal care and adopting health care behavior that optimize fetal and neonatal well-being."
This document was found at the Minnesota Department of Health website and is from the US Department of Health. It would seem that the US Department of health does not endorse coercive measures to hiv positive women and their babies. Although they support the use of toxic drugs. Reading some of the pages in this document about the side effects of these drugs, would make most women concerned about the well being of their babies. About half of the authors to this report have declared fundings from various pharmaceutical industries (10 out of 28 authors). see page 2 of the document.
I just recently listened to an abc.13 video of an interview with Dr. Mark Kline, President and Founder of Baylor International Pediatric AIDS Intiative. see http://www.bipai.org
In which he is responding to the case of the infant supposedly cured of hiv/aids. He does not believe that is possible. Nor is he aginst hiv drugs for pregnant women. In fact, he seems to think that is the preventative step. His organization is funded by the Abbott Fund and Bristol Myers Squibb Foundation (Abbott and Bristol Myers Squibb are pharmaceutical companies who have made quite a bit of money from hiv/aids drugs and test kits). One of his executive directors, Gabriel M. Anabwani is chairperson of the Nestle Nutrition Institute Africa and on the technical expert committee for UNICEF and WHO. Nestle does have some commercial interests in hiv/aids policies.
The last minute of Kline's comments are about the importance of not testing for hiv in newborns of mothers who did not get the hiv meds in pregnancy but were found to be hiv positive at the delivery of their babies. His concern was about giving toxic meds to babies who were not actually hiv positive.
There is a rush to use these medications on pregnant mothers and newborns. That rush involves the use of Child Protective Services as a threat to make sure all mothers and babies receive these meds. These drugs are DNA chain terminators, meaning they kill DNA. While it would appear to some people that a pregnant mother is irrational and negligent to refuse the drugs for herself and the unborn baby/infant; it seems to me that the irrational people are the ones who think giving toxic drugs to pregnant women and infants is the answer. It may stop transmission but it is very questionable whether it gives hiv mothers and babies quality of life--particularly coupled with threats from Child Protective Servies.
Copyright 2013 Valerie W. McClain
For further information on the drug AZT usage in Pregnancy and in Children, I recommend, "AZT: Unsafe at Any Dose?"
One of the more bothersome aspects of hiv transmission from mother to child is that prior to the recommendation of use of drugs (AZT, etc), the transmission rates were 16%-25% in the USA and Europe. What that means to me is that 75%-84% of infants were not positive for hiv; either were born hiv negative or converted at some time during their infancy despite their mothers being hiv positive. (that is if you believe in the infallibility of hiv testing). Yet current and past policy recommendations written by the US Government are that all babies of hiv positive mothers must take treatment.
from the CDC, "Revised Recommendations for HIV Screening of Pregnant Women," dated April 1999.
"Before the results of the PACTG 076 trial using prenatal, intrapartum, and postpartum ZDV for perinatal prophylaxis, the risk for mother-to-child transmission ranged from 16% to 25% in studies from North America and Europe (17--19), up to 24% in Thailand (20), and 25--40% in Africa (21,22)."
Cited to a study by Dunn et al.
What adult would take treatment for a disease because they were in a at-risk population in which 75%-84% would not get the disease? Particularly if the drugs have side effects like AZT? It makes little to no sense. Even if the drugs were "just" antibiotics, would you take them because you are in the at-risk population? What is that famous saying about physicians? "First do no harm?"