Growth and neurodevelopment in HIV-uninfected children born from HIV-infected women in a public general hospital from Argentina
J. Lattner1, M.E. Socías1, M.F. Buraschi2, M.T. Sepulveda2, I. Beloso3, G. Elbert1, G. Blugerman1, P. Caro1, H. Pérez1, P. Cahn1
1Hospital Juan A. Fernández, Infectious Diseases Unit, Buenos Aires, Argentina, 2Hospital Juan A. Fernández, Neonatology Unit, Buenos Aires, Argentina, 3Hospital Juan A. Fernández, Phonoaudiology Section, Buenos Aires, Argentina
Introduction: It is uncertain whether intrauterine exposure to HIV or ARV affects growth and neurodevelopment in early life.
Objective: To analyze anthropometric growth and neurodevelopment parameters in HIV-uninfected children born from HIV-infected mothers.
Methods: Prospective observational study of HIV-uninfected children born from HIV-infected mothers followed at a public hospital in Buenos Aires during the first 24 months of life between 2000-2007. Neurodevelopment was assessed by Bayley Scales of Infant Development-II (BSID-II), expected mean: 100 (SD 15). Growth patterns were compared with WHO 2006 standards using the LMS method. Descriptive statistics and T-test were used.
Results: n=154 (F/M: 69/85). Median maternal age: 29 years (IQR 25-32). Intrauterine ARV exposure: 131 babies (86%). Cesarean section: 71.5%. Preterm births: 16.3%. All newborns received postnatal AZT for 42 days. Mean weight: 3041 g (SD 579) and 3192 g (SD 512), excluding premature neonates (p=0.03). Mean weight, height and occipitofrontal circumference (OFC) were lower than WHO standards [respective mean z-scores: -0.63, -1.02, -0.36]. These differences tend to disappear when premature neonates were excluded [respective mean z-scores: -0.28, -0.83, -0.04]. At 12 months (n=113), anthropometric measures were comparable to WHO standards [mean z-scores for weight 0.17, height -0.42 and OFC 0.4], keeping similar values to the end of follow-up. Mean BSID-II: 101.4 (SD 11.42). Intrauterine exposure to ARV did not influence neither growth nor neurodevelopment in our study (p=NS).
Conclusions: Exposed children are smaller at birth but catch-up at 12 months. This difference is probably driven by the high proportion of premature neonates seen in our cohort. Neurodevelopment was within normal parameters. Intrauterine exposure to HIV or ARV did not alter growth or neurodevelopment in this cohort of uninfected children at least during the first 24 months of life. These findings add further evidence to the positive risk-benefit ratio of ARV therapy in preventing vertical transmission of HIV.
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