Journal Article

Time-independent Maternal and Infant Factors and Time-dependent Infant Morbidities including HIV Infection, Contribute to Infant Growth Faltering during the First 2 Years of Life

Aimee L. Webb, Karim Manji, Wafaie W. Fawzi and Eduardo Villamor

in Journal of Tropical Pediatrics

Volume 55, issue 2, pages 83-90
Published in print April 2009 | ISSN: 0142-6338
Published online August 2008 | e-ISSN: 1465-3664 | DOI: http://dx.doi.org/10.1093/tropej/fmn068
Time-independent Maternal and Infant Factors and Time-dependent Infant Morbidities including HIV Infection, Contribute to Infant Growth Faltering during the First 2 Years of Life

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Studies investigating the predictors of growth in infants born to HIV-infected women in developing countries are limited. Using data from 886 Tanzanian HIV-infected women and their infants, we examined the impact of maternal socioeconomic and immunological status, infant characteristics at birth, and HIV, diarrhea and respiratory infections on infants’ monthly length-for-age (LAZ) and length-for-weight (WLZ) z-scores during the first 2 years of life. We used restricted cubic splines to estimate average adjusted growth curves by categories of each predictor. LAZ decreased significantly during the first 2 years. WLZ increased from birth to 4 months but decreased significantly thereafter. Greater maternal schooling significantly reduced deterioration in LAZ and WLZ scores from birth to 24 months, while maternal CD4 cell counts 200 mm−3 at baseline were associated with reduced deterioration in LAZ scores. Infants born pre-term or with low-birth weight were significantly more stunted and wasted than their reference groups at all time points though their rate of growth faltering was slower. Infant-HIV status was strongly associated with significantly greater deterioration in LAZ and WLZ scores, beginning at about 4 months of age. Episodes of diarrhea or respiratory infections were related to significantly lower WLZ but not LAZ scores, independent of infant-HIV status. In conclusion, maternal schooling, immunological status and infant infections are important predictors of early growth in children born to HIV-positive women.

Keywords: HIV; growth; infants; morbidity; Tanzania; LAZ scores; WLZ scores

Journal Article.  3938 words.  Illustrated.

Subjects: Paediatrics

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