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
Identifieur interne : 005C88 ( Main/Exploration ); précédent : 005C87; suivant : 005C89Time-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
Auteurs : Aimee L. Webb [Canada] ; Karim Manji [Tanzanie] ; Wafaie W. Fawzi [États-Unis] ; Eduardo Villamor [États-Unis]Source :
- Journal of Tropical Pediatrics [ 0142-6338 ] ; 2009-04.
Abstract
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.
Url:
- https://api.istex.fr/document/C689DA9FC02F7FF1DE23410AEAA5E2B327E09FB5/fulltext/pdf
- http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2734313
DOI: 10.1093/tropej/fmn068
Affiliations:
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<front><div type="abstract">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.</div>
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