Growth Faltering and Developmental Delay in HIV-Exposed Uninfected Ugandan Infants: A Prospective Cohort Study
| Autor: | Michael Hawkes, Bukola O Salami, Sophie Namasopo, Reshma Sirajee, Sarah E. Forgie, Stephanie Lavoie, Andrea L. Conroy, Robert O. Opoka |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Malawi Birth weight Human immunodeficiency virus (HIV) HIV Infections MDAT Growth faltering 030312 virology medicine.disease_cause 03 medical and health sciences Child Development Pregnancy Medicine Birth Weight Humans Pharmacology (medical) Uganda Prospective Studies Prospective cohort study 0303 health sciences business.industry Infant Infant Low Birth Weight Failure to Thrive Infectious Diseases Cross-Sectional Studies Maternal Exposure Cohort Developmental Milestone Failure to thrive Female medicine.symptom business |
| Zdroj: | Journal of acquired immune deficiency syndromes (1999). 87(1) |
| ISSN: | 1944-7884 |
| Popis: | BACKGROUND HIV-exposed but uninfected (HEU) infants are at increased risk of impaired early linear growth and cognitive development. We examined associations between prenatal and postnatal growth and subsequent neurodevelopment in Ugandan HEU infants, hypothesizing that early insults may explain alterations in both somatic growth and brain development. METHODS We prospectively followed a cohort of HEU infants from birth to 18 months of age, and measured length/height, weight, head, and arm circumference longitudinally. The Malawi Development Assessment Tool (MDAT, 12 and 18 months) and the Color Object Association Test (18 months) were used for developmental assessments. RESULTS Among 170 HEU infants, the prevalence of low-birth weight and failure to thrive was 7.6% and 37%, respectively. HEU infants had MDAT scores that were similar to the reference population. The mean (SD) score on the Color Object Association Test was 5.5 (3.1) compared with 6.9 (5.3) in developmentally normal children. Developmental ability at age 18 months showed strong cross-sectional correlation with weight-for-age (ρ = 0.36, P < 0.0001), length/height-for-age (ρ = 0.41, P < 0.0001), head circumference-for-age (ρ = 0.26, P = 0.0011), and mid-upper arm circumference-for-age (ρ = 0.34, P = 0.0014). There was a statistically significant correlation between birth weight and MDAT z-score at 18 months (ρ = 0.20, P = 0.010). Failure to thrive was associated with lower MDAT z-score [median -0.13 (IQR -0.75 to +0.14) versus +0.14 (IQR -0.44 to +0.63), P = 0.042]. CONCLUSION Growth faltering in HEU infants was associated with lower attainment of developmental milestones at age 18 months. Our findings point to a simple screening method for identifying HEU infants at risk for developmental intervention. |
| Databáze: | OpenAIRE |
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