Objective: To compare the growth patterns in the first year
of life between children born to perinatally HIV-infected (PHIV) vs.
nonperinatally HIV-infected (NPHIV) women in the United States.
Design: Retrospective cohort study of HIV-infected pregnant
women who received care and delivered a live-born at two urban tertiary centers
from January 2004 to March 2012.
Methods: We collected data via chart review on demographics,
behavioral risk factors, HIV clinical markers, combination antiretroviral
therapy (cART), mode of HIV acquisition, pregnancy outcomes, and infant
anthropometrics on study participants. Mixed-effects models were used to assess
the association between maternal mode of HIV acquisition and weight-for-age z-score
(WAZ), length-for-age z-score (LAZ), and weight-for-length z-score
(WLZ).
Results: Of the 152 pregnancies evaluated, 32 and 120
infants were born to 25 PHIV and 99 NPHIV women, respectively. Infants of PHIV
women exhibited lower mean WAZ and LAZ throughout the first year of life in
unadjusted analyses. After adjusting for potential confounders, the
relationship between PHIV women and LAZ persisted (β = −0.54, P = 0.026).
Small-for-gestational age for each birth anthropometric parameter (birth
length, birth weight, and both birth length and weight) was associated with
decreased LAZ (β = −0.48, P = 0.007), WAZ (β = −0.99, P < 0.001),
and WLZ (β = −0.36, P = 0.027), respectively. A
delivery HIV RNA level below 400 copies/ml was associated with increased WAZ
and WLZ (β = 0.43, P = 0.015 and β = 0.38, P = 0.021,
respectively).
Conclusions: Infants of PHIV women may remain at
persistently decreased lengths throughout the first year of life. Further
studies aimed at understanding intrauterine and environmental factors in PHIV
women are warranted.
Below: Loess Plots of Mean Weight for Age (WAZ), Length for Age (LAZ), and Weight for Length (WLZ) Z-scores by Maternal Mode of HIV Acquisition
Full article at:
- 1aDepartment of Medicine, Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York bDepartment of Pediatrics, Division of Infectious Diseases, Johns Hopkins University School of Medicine c Department of Medicine dDepartment of Pediatrics, Icahn School of Medicine at Mount Sinai eICAP, Mailman School of Public Health and College of Physicians & Surgeons, Columbia University, New York fDepartment of Pediatrics, Johns Hopkins University School of Medicine gDepartment of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, USA.
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