Growth of HIV-Exposed Uninfected Infants in the First 6 Months of Life in South Africa: The IeDEA-SA Collaboration
Identifieur interne : 000416 ( Pmc/Curation ); précédent : 000415; suivant : 000417Growth of HIV-Exposed Uninfected Infants in the First 6 Months of Life in South Africa: The IeDEA-SA Collaboration
Auteurs : Erna Morden [Afrique du Sud] ; Karl-Günter Technau [Afrique du Sud] ; Janet Giddy [Afrique du Sud] ; Nicola Maxwell [Afrique du Sud] ; Olivia Keiser [Suisse] ; Mary-Ann Davies [Afrique du Sud]Source :
- PLoS ONE [ 1932-6203 ] ; 2016.
Abstract
HIV-exposed uninfected (HEU) infants are a growing population in sub-Saharan Africa especially with the increasing coverage of more effective prevention of mother-to-child transmission (PMTCT) antiretroviral therapy regimens. This study describes the characteristics of South African HEU infants, investigates factors impacting birth weight and assesses their growth within the first 28 weeks of life.
This is a retrospective cohort based on routine clinical data from two South African PMTCT programmes. Data were collected between 2007 and 2013. Linear regression assessed factors affecting birth weight-for-age z-scores (WAZ) while growth (longitudinal WAZ) was assessed using mixed effects models.
We assessed the growth of 2621 HEU infants (median birth WAZ was -0.65 (IQR -1.46; 0.0) and 51% were male). The feeding modalities practised were as follows: 0.5% exclusive breastfeeding, 7.9% breastfeeding with unknown exclusivity, 0.08% mixed breastfeeding and 89.2% formula feeding. Mothers with CD4 <200 cells/μl delivered infants with a lower birth WAZ (adjusted ß -0.253 [95% CI -0.043; -0.072], p = 0.006) compared to mothers with aCD4 ≥500 cells/μl. Similarly, mothers who did not receive antiretroviral drugs delivered infants with a lower birth WAZ (adjusted ß -0.39 [95% CI -0.67; -0.11], p = 0.007) compared to mothers who received antenatal antiretrovirals. Infants with a birth weight <2 500g (ß 0.070 [95% CI 0.061; 0.078], p <0.0001) experienced faster growth within the first 28 weeks of life compared to infants with a birth weight ≥2 500g. Infants with any breastfeeding exposure experienced slower longitudinal growth compared to formula fed infants (adjusted ß -0.012 [95% CI 0.021; -0.003], p = 0.011).
Less severe maternal disease and the use of antiretrovirals positively impacts birth weight in this cohort of South African HEU infants. Formula feeding was common with breastfed infants experiencing marginally slower longitudinal growth.
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DOI: 10.1371/journal.pone.0151762
PubMed: 27049853
PubMed Central: 4822941
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Growth of HIV-Exposed Uninfected Infants in the First 6 Months of Life in South Africa: The IeDEA-SA Collaboration</title><author><name sortKey="Morden, Erna" sort="Morden, Erna" uniqKey="Morden E" first="Erna" last="Morden">Erna Morden</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa</addr-line></nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>School of Public Health and Family Medicine, University of Cape Town, Cape Town</wicri:regionArea></affiliation></author><author><name sortKey="Technau, Karl Gunter" sort="Technau, Karl Gunter" uniqKey="Technau K" first="Karl-Günter" last="Technau">Karl-Günter Technau</name><affiliation wicri:level="1"><nlm:aff id="aff002"><addr-line>Rahima Moosa Mother and Child Hospital and University of the Witwatersrand, Johannesburg, South Africa</addr-line></nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Rahima Moosa Mother and Child Hospital and University of the Witwatersrand, Johannesburg</wicri:regionArea></affiliation></author><author><name sortKey="Giddy, Janet" sort="Giddy, Janet" uniqKey="Giddy J" first="Janet" last="Giddy">Janet Giddy</name><affiliation wicri:level="1"><nlm:aff id="aff003"><addr-line>McCord Hospital, Durban, South Africa</addr-line></nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>McCord Hospital, Durban</wicri:regionArea></affiliation></author><author><name sortKey="Maxwell, Nicola" sort="Maxwell, Nicola" uniqKey="Maxwell N" first="Nicola" last="Maxwell">Nicola Maxwell</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa</addr-line></nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>School of Public Health and Family Medicine, University of Cape Town, Cape Town</wicri:regionArea></affiliation></author><author><name sortKey="Keiser, Olivia" sort="Keiser, Olivia" uniqKey="Keiser O" first="Olivia" last="Keiser">Olivia Keiser</name><affiliation wicri:level="1"><nlm:aff id="aff004"><addr-line>Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland</addr-line></nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>Institute of Social and Preventive Medicine, University of Bern, Bern</wicri:regionArea></affiliation></author><author><name sortKey="Davies, Mary Ann" sort="Davies, Mary Ann" uniqKey="Davies M" first="Mary-Ann" last="Davies">Mary-Ann Davies</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa</addr-line></nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>School of Public Health and Family Medicine, University of Cape Town, Cape Town</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">27049853</idno><idno type="pmc">4822941</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4822941</idno><idno type="RBID">PMC:4822941</idno><idno type="doi">10.1371/journal.pone.0151762</idno><date when="2016">2016</date><idno type="wicri:Area/Pmc/Corpus">000416</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000416</idno><idno type="wicri:Area/Pmc/Curation">000416</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000416</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Growth of HIV-Exposed Uninfected Infants in the First 6 Months of Life in South Africa: The IeDEA-SA Collaboration</title><author><name sortKey="Morden, Erna" sort="Morden, Erna" uniqKey="Morden E" first="Erna" last="Morden">Erna Morden</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa</addr-line></nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>School of Public Health and Family Medicine, University of Cape Town, Cape Town</wicri:regionArea></affiliation></author><author><name sortKey="Technau, Karl Gunter" sort="Technau, Karl Gunter" uniqKey="Technau K" first="Karl-Günter" last="Technau">Karl-Günter Technau</name><affiliation wicri:level="1"><nlm:aff id="aff002"><addr-line>Rahima Moosa Mother and Child Hospital and University of the Witwatersrand, Johannesburg, South Africa</addr-line></nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Rahima Moosa Mother and Child Hospital and University of the Witwatersrand, Johannesburg</wicri:regionArea></affiliation></author><author><name sortKey="Giddy, Janet" sort="Giddy, Janet" uniqKey="Giddy J" first="Janet" last="Giddy">Janet Giddy</name><affiliation wicri:level="1"><nlm:aff id="aff003"><addr-line>McCord Hospital, Durban, South Africa</addr-line></nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>McCord Hospital, Durban</wicri:regionArea></affiliation></author><author><name sortKey="Maxwell, Nicola" sort="Maxwell, Nicola" uniqKey="Maxwell N" first="Nicola" last="Maxwell">Nicola Maxwell</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa</addr-line></nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>School of Public Health and Family Medicine, University of Cape Town, Cape Town</wicri:regionArea></affiliation></author><author><name sortKey="Keiser, Olivia" sort="Keiser, Olivia" uniqKey="Keiser O" first="Olivia" last="Keiser">Olivia Keiser</name><affiliation wicri:level="1"><nlm:aff id="aff004"><addr-line>Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland</addr-line></nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>Institute of Social and Preventive Medicine, University of Bern, Bern</wicri:regionArea></affiliation></author><author><name sortKey="Davies, Mary Ann" sort="Davies, Mary Ann" uniqKey="Davies M" first="Mary-Ann" last="Davies">Mary-Ann Davies</name><affiliation wicri:level="1"><nlm:aff id="aff001"><addr-line>School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa</addr-line></nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>School of Public Health and Family Medicine, University of Cape Town, Cape Town</wicri:regionArea></affiliation></author></analytic><series><title level="j">PLoS ONE</title><idno type="eISSN">1932-6203</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="sec001"><title>Background</title><p>HIV-exposed uninfected (HEU) infants are a growing population in sub-Saharan Africa especially with the increasing coverage of more effective prevention of mother-to-child transmission (PMTCT) antiretroviral therapy regimens. This study describes the characteristics of South African HEU infants, investigates factors impacting birth weight and assesses their growth within the first 28 weeks of life.</p></sec><sec id="sec002"><title>Methods</title><p>This is a retrospective cohort based on routine clinical data from two South African PMTCT programmes. Data were collected between 2007 and 2013. Linear regression assessed factors affecting birth weight-for-age z-scores (WAZ) while growth (longitudinal WAZ) was assessed using mixed effects models.</p></sec><sec id="sec003"><title>Results</title><p>We assessed the growth of 2621 HEU infants (median birth WAZ was -0.65 (IQR -1.46; 0.0) and 51% were male). The feeding modalities practised were as follows: 0.5% exclusive breastfeeding, 7.9% breastfeeding with unknown exclusivity, 0.08% mixed breastfeeding and 89.2% formula feeding. Mothers with CD4 <200 cells/μl delivered infants with a lower birth WAZ (adjusted ß -0.253 [95% CI -0.043; -0.072], p = 0.006) compared to mothers with aCD4 ≥500 cells/μl. Similarly, mothers who did not receive antiretroviral drugs delivered infants with a lower birth WAZ (adjusted ß -0.39 [95% CI -0.67; -0.11], p = 0.007) compared to mothers who received antenatal antiretrovirals. Infants with a birth weight <2 500g (ß 0.070 [95% CI 0.061; 0.078], p <0.0001) experienced faster growth within the first 28 weeks of life compared to infants with a birth weight ≥2 500g. Infants with any breastfeeding exposure experienced slower longitudinal growth compared to formula fed infants (adjusted ß -0.012 [95% CI 0.021; -0.003], p = 0.011).</p></sec><sec id="sec004"><title>Conclusion</title><p>Less severe maternal disease and the use of antiretrovirals positively impacts birth weight in this cohort of South African HEU infants. 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sortKey="Scott, N" uniqKey="Scott N">N Scott</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Iliff, P" uniqKey="Iliff P">P Iliff</name></author><author><name sortKey="Piwoz, E" uniqKey="Piwoz E">E Piwoz</name></author><author><name sortKey="Tavengwa, N" uniqKey="Tavengwa N">N Tavengwa</name></author><author><name sortKey="Zunguza, C" uniqKey="Zunguza C">C Zunguza</name></author><author><name sortKey="Marinda, E" uniqKey="Marinda E">E Marinda</name></author><author><name sortKey="Nathoo, K" uniqKey="Nathoo K">K Nathoo</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">PLoS One</journal-id><journal-id journal-id-type="iso-abbrev">PLoS ONE</journal-id><journal-id journal-id-type="publisher-id">plos</journal-id><journal-id journal-id-type="pmc">plosone</journal-id><journal-title-group><journal-title>PLoS ONE</journal-title></journal-title-group><issn pub-type="epub">1932-6203</issn><publisher><publisher-name>Public Library of Science</publisher-name><publisher-loc>San Francisco, CA USA</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">27049853</article-id><article-id pub-id-type="pmc">4822941</article-id><article-id pub-id-type="doi">10.1371/journal.pone.0151762</article-id><article-id pub-id-type="publisher-id">PONE-D-15-54740</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="Discipline-v3"><subject>People and Places</subject><subj-group><subject>Population Groupings</subject><subj-group><subject>Age Groups</subject><subj-group><subject>Children</subject><subj-group><subject>Infants</subject></subj-group></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>People and Places</subject><subj-group><subject>Population Groupings</subject><subj-group><subject>Families</subject><subj-group><subject>Children</subject><subj-group><subject>Infants</subject></subj-group></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Biology and Life Sciences</subject><subj-group><subject>Physiology</subject><subj-group><subject>Physiological Parameters</subject><subj-group><subject>Body Weight</subject><subj-group><subject>Birth Weight</subject></subj-group></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject><subj-group><subject>Physiology</subject><subj-group><subject>Physiological Parameters</subject><subj-group><subject>Body Weight</subject><subj-group><subject>Birth Weight</subject></subj-group></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject><subj-group><subject>Pharmacology</subject><subj-group><subject>Drugs</subject><subj-group><subject>Antimicrobials</subject><subj-group><subject>Antivirals</subject><subj-group><subject>Antiretrovirals</subject></subj-group></subj-group></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Biology and Life Sciences</subject><subj-group><subject>Microbiology</subject><subj-group><subject>Microbial Control</subject><subj-group><subject>Antimicrobials</subject><subj-group><subject>Antivirals</subject><subj-group><subject>Antiretrovirals</subject></subj-group></subj-group></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Biology and Life Sciences</subject><subj-group><subject>Microbiology</subject><subj-group><subject>Virology</subject><subj-group><subject>Antivirals</subject><subj-group><subject>Antiretrovirals</subject></subj-group></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Biology and Life Sciences</subject><subj-group><subject>Immunology</subject><subj-group><subject>Vaccination and Immunization</subject><subj-group><subject>Antiviral Therapy</subject><subj-group><subject>Antiretroviral Therapy</subject></subj-group></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject><subj-group><subject>Immunology</subject><subj-group><subject>Vaccination and Immunization</subject><subj-group><subject>Antiviral Therapy</subject><subj-group><subject>Antiretroviral Therapy</subject></subj-group></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject><subj-group><subject>Public and Occupational Health</subject><subj-group><subject>Preventive Medicine</subject><subj-group><subject>Vaccination and Immunization</subject><subj-group><subject>Antiviral Therapy</subject><subj-group><subject>Antiretroviral Therapy</subject></subj-group></subj-group></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject><subj-group><subject>Women's Health</subject><subj-group><subject>Maternal Health</subject><subj-group><subject>Breast Feeding</subject></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject><subj-group><subject>Pediatrics</subject><subj-group><subject>Neonatology</subject><subj-group><subject>Breast Feeding</subject></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject><subj-group><subject>Women's Health</subject><subj-group><subject>Maternal Health</subject><subj-group><subject>Birth</subject><subj-group><subject>Labor and Delivery</subject></subj-group></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Medicine and Health Sciences</subject><subj-group><subject>Women's Health</subject><subj-group><subject>Obstetrics and Gynecology</subject><subj-group><subject>Birth</subject><subj-group><subject>Labor and Delivery</subject></subj-group></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Research and Analysis Methods</subject><subj-group><subject>Mathematical and Statistical Techniques</subject><subj-group><subject>Statistical Methods</subject><subj-group><subject>Regression Analysis</subject><subj-group><subject>Linear Regression Analysis</subject></subj-group></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Physical Sciences</subject><subj-group><subject>Mathematics</subject><subj-group><subject>Statistics (Mathematics)</subject><subj-group><subject>Statistical Methods</subject><subj-group><subject>Regression Analysis</subject><subj-group><subject>Linear Regression Analysis</subject></subj-group></subj-group></subj-group></subj-group></subj-group></subj-group><subj-group subj-group-type="Discipline-v3"><subject>Biology and Life Sciences</subject><subj-group><subject>Cell Biology</subject><subj-group><subject>Cell Processes</subject><subj-group><subject>Cell Cycle and Cell Division</subject></subj-group></subj-group></subj-group></subj-group></article-categories><title-group><article-title>Growth of HIV-Exposed Uninfected Infants in the First 6 Months of Life in South Africa: The IeDEA-SA Collaboration</article-title><alt-title alt-title-type="running-head">Growth of South African HIV-Exposed Uninfected Infants</alt-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Morden</surname><given-names>Erna</given-names></name><xref ref-type="aff" rid="aff001"><sup>1</sup></xref><xref ref-type="corresp" rid="cor001">*</xref></contrib><contrib contrib-type="author"><name><surname>Technau</surname><given-names>Karl-Günter</given-names></name><xref ref-type="aff" rid="aff002"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>Giddy</surname><given-names>Janet</given-names></name><xref ref-type="aff" rid="aff003"><sup>3</sup></xref></contrib><contrib contrib-type="author"><name><surname>Maxwell</surname><given-names>Nicola</given-names></name><xref ref-type="aff" rid="aff001"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Keiser</surname><given-names>Olivia</given-names></name><xref ref-type="aff" rid="aff004"><sup>4</sup></xref></contrib><contrib contrib-type="author"><name><surname>Davies</surname><given-names>Mary-Ann</given-names></name><xref ref-type="aff" rid="aff001"><sup>1</sup></xref></contrib></contrib-group><aff id="aff001"><label>1</label><addr-line>School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa</addr-line></aff><aff id="aff002"><label>2</label><addr-line>Rahima Moosa Mother and Child Hospital and University of the Witwatersrand, Johannesburg, South Africa</addr-line></aff><aff id="aff003"><label>3</label><addr-line>McCord Hospital, Durban, South Africa</addr-line></aff><aff id="aff004"><label>4</label><addr-line>Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland</addr-line></aff><contrib-group><contrib contrib-type="editor"><name><surname>Nixon</surname><given-names>Douglas F.</given-names></name><role>Editor</role><xref ref-type="aff" rid="edit1"></xref></contrib></contrib-group><aff id="edit1"><addr-line>George Washington University, UNITED STATES</addr-line></aff><author-notes><fn fn-type="conflict" id="coi001"><p><bold>Competing Interests: </bold>The authors have declared that no competing interests exist.</p></fn><fn fn-type="con" id="contrib001"><p>Conceived and designed the experiments: EM KGT JG NM OK MAD. Performed the experiments: EM MAD. Analyzed the data: EM MAD. Contributed reagents/materials/analysis tools: KGT JG NM OK MAD. Wrote the paper: EM KGT JG NM OK MAD. Contributed to data acquisition: KGT JG NM. Contributed to data interpretation: EM KGT JG NM OK MAD. Gave final approval for manuscript submission: EM KGT JG NM OK MAD. Accountable for all aspects of the work: EM KGT JG NM OK MAD.</p></fn><corresp id="cor001">* E-mail: <email>erna.morden@alumni.uct.ac.za</email></corresp></author-notes><pub-date pub-type="epub"><day>6</day><month>4</month><year>2016</year></pub-date><pub-date pub-type="collection"><year>2016</year></pub-date><volume>11</volume><issue>4</issue><elocation-id>e0151762</elocation-id><history><date date-type="received"><day>17</day><month>12</month><year>2015</year></date><date date-type="accepted"><day>3</day><month>3</month><year>2016</year></date></history><permissions><copyright-statement>© 2016 Morden et al</copyright-statement><copyright-year>2016</copyright-year><copyright-holder>Morden et al</copyright-holder><license xlink:href="http://creativecommons.org/licenses/by/4.0/"><license-p>This is an open access article distributed under the terms of the <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">Creative Commons Attribution License</ext-link>, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</license-p></license></permissions><self-uri content-type="pdf" xlink:type="simple" xlink:href="pone.0151762.pdf"></self-uri><abstract><sec id="sec001"><title>Background</title><p>HIV-exposed uninfected (HEU) infants are a growing population in sub-Saharan Africa especially with the increasing coverage of more effective prevention of mother-to-child transmission (PMTCT) antiretroviral therapy regimens. This study describes the characteristics of South African HEU infants, investigates factors impacting birth weight and assesses their growth within the first 28 weeks of life.</p></sec><sec id="sec002"><title>Methods</title><p>This is a retrospective cohort based on routine clinical data from two South African PMTCT programmes. Data were collected between 2007 and 2013. Linear regression assessed factors affecting birth weight-for-age z-scores (WAZ) while growth (longitudinal WAZ) was assessed using mixed effects models.</p></sec><sec id="sec003"><title>Results</title><p>We assessed the growth of 2621 HEU infants (median birth WAZ was -0.65 (IQR -1.46; 0.0) and 51% were male). The feeding modalities practised were as follows: 0.5% exclusive breastfeeding, 7.9% breastfeeding with unknown exclusivity, 0.08% mixed breastfeeding and 89.2% formula feeding. Mothers with CD4 <200 cells/μl delivered infants with a lower birth WAZ (adjusted ß -0.253 [95% CI -0.043; -0.072], p = 0.006) compared to mothers with aCD4 ≥500 cells/μl. Similarly, mothers who did not receive antiretroviral drugs delivered infants with a lower birth WAZ (adjusted ß -0.39 [95% CI -0.67; -0.11], p = 0.007) compared to mothers who received antenatal antiretrovirals. Infants with a birth weight <2 500g (ß 0.070 [95% CI 0.061; 0.078], p <0.0001) experienced faster growth within the first 28 weeks of life compared to infants with a birth weight ≥2 500g. Infants with any breastfeeding exposure experienced slower longitudinal growth compared to formula fed infants (adjusted ß -0.012 [95% CI 0.021; -0.003], p = 0.011).</p></sec><sec id="sec004"><title>Conclusion</title><p>Less severe maternal disease and the use of antiretrovirals positively impacts birth weight in this cohort of South African HEU infants. Formula feeding was common with breastfed infants experiencing marginally slower longitudinal growth.</p></sec></abstract><funding-group><funding-statement>NIH (National Institute of Health) NIAID (National Institute of Allergy and Infectious Diseases) Eunice Kennedy Shriver NICHD (National Institute of Child Health and Human Development) Grant number 5U01AI069924 The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.</funding-statement></funding-group><counts><fig-count count="1"></fig-count><table-count count="5"></table-count><page-count count="15"></page-count></counts><custom-meta-group><custom-meta id="data-availability"><meta-name>Data Availability</meta-name><meta-value>Data are accessible in principle by applying for access directly from each contributing cohort. The IeDEA-SA dataset is a multi-site collaboration and this analysis combined data from different sites. (For more information, see <ext-link ext-link-type="uri" xlink:href="http://www.iedea-sa.org/">http://www.iedea-sa.org</ext-link>.) The data do not belong to IeDEA-SA; data ownership remains with the participating sites. Each site has approval from its own local Institutional Review Board to collect routine data on patients and to transfer these data anonymously to the IeDEA-SA data centre, for use in collaborative analyses. Interested readers may contact the site investigators to request the data, and this can be facilitated by the IeDEA-SA project manager, Dr. Morna Cornell (<email>morna.cornell@uct.ac.za</email>).</meta-value></custom-meta></custom-meta-group></article-meta><notes><title>Data Availability</title><p>Data are accessible in principle by applying for access directly from each contributing cohort. The IeDEA-SA dataset is a multi-site collaboration and this analysis combined data from different sites. (For more information, see <ext-link ext-link-type="uri" xlink:href="http://www.iedea-sa.org/">http://www.iedea-sa.org</ext-link>.) The data do not belong to IeDEA-SA; data ownership remains with the participating sites. Each site has approval from its own local Institutional Review Board to collect routine data on patients and to transfer these data anonymously to the IeDEA-SA data centre, for use in collaborative analyses. Interested readers may contact the site investigators to request the data, and this can be facilitated by the IeDEA-SA project manager, Dr. Morna Cornell (<email>morna.cornell@uct.ac.za</email>).</p></notes></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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