HIV-Exposed, Uninfected Infants in Uganda Experience Poorer Growth and Body Composition Trajectories than HIV-Unexposed Infants

Lane, Charlotte; Widen, Elizabeth M.; Collins, Steven M.; Young, Sera L.

doi:10.1097/qai.0000000000002428

Cited by 13 publications

(12 citation statements)

References 37 publications

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“…In our study, a lower mean LAZ was found in HEU infants at 6 months, which is similar to another South African study [ 58 ], and a lower mean HCZ was also reported in Zimbabwe at 6 months [ 59 ]. A lower mean LAZ was also observed at 9 months in HEU infants as compared to HUU infants, similar to other studies in Uganda [ 60 ], Rwanda [ 61 ], and Botswana [ 10 ]. HEU infants were at a higher risk of being stunted (12.5% vs. 7.1%) at 9 months as compared to HUU infants.…”

Section: Discussionsupporting

confidence: 89%

Comparison of Feeding Practices and Growth of Urbanized African Infants Aged 6–12 Months Old by Maternal HIV Status in Gauteng Province, South Africa

et al. 2023

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Appropriate feeding practices are protective against malnutrition and poor growth. We compared feeding practices and growth in HIV-exposed-uninfected (HEU) and HIV-unexposed-uninfected (HUU) between 6-12 months of age in urbanized African infants in South Africa. A repeated cross-sectional analysis was used to determine differences in infant feeding practices and anthropometric measures by HIV exposure status at 6, 9, and 12 months in the Siyakhula study. The study included 181 infants (86 HEU; 95 HUU). Breastfeeding rates were lower in HEU vs. HUU infants at 9 (35.6% vs. 57.3%; p = 0.013) and 12 months (24.7% vs. 48.0%; p = 0.005). Introduction to early complementary foods was common (HEU = 16.2 ± 11.0 vs. HUU = 12.8 ± 9.3 weeks; p = 0.118). Lower weight-for-age Z-scores (WAZ) and head circumference-for-age Z-scores (HCZ) were found in HEU infants at birth. At 6 months, WAZ, length-for-age Z-scores (LAZ), HCZ, and mid-upper-arm circumference-for-age Z-scores (MUACAZ) were lower in HEU vs. HUU infants. At 9 months, lower WAZ, LAZ, and MUACAZ were found in HEU vs. HUU infants. At 12 months, lower WAZ, MUACAZ, and weight-for-length Z-scores (−0.2 ± 1.2 vs. 0.2 ± 1.2; p = 0.020) were observed. HEU infants had lower rates of breastfeeding and poorer growth compared to HUU infants. Maternal HIV exposure affects the feeding practices and growth of infants.

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Section: Discussionsupporting

confidence: 89%

Comparison of Feeding Practices and Growth of Urbanized African Infants Aged 6–12 Months Old by Maternal HIV Status in Gauteng Province, South Africa

et al. 2023

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“…In a recent systematic review, 14 studies had used some form of growth mixture modelling to investigate BMI trajectories starting at birth and another 49 to investigate BMI trajectories starting at some time after birth 49 . We could only, however, find 7 studies which had investigated latent patterns of early childhood body weight trajectories 18‐24 . In one publication, a growth mixture model was developed using serial weight Z ‐scores (according to the WHO Standards) between 0 and 36 months in 1364 singleton, term infants 22,50 .…”

Section: Commentmentioning

confidence: 99%

“…While simple, easily identifiable traits are unarguably a core and important aspect of growth monitoring, a better understanding of the different patterns of early childhood weight gain that may exist in a population is needed and would be informative for those interested in monitoring the growth of children. Numerous papers have summarised early childhood weight trajectories in terms of individual‐level traits, 5,9‐11 but we are only aware of seven publications that have analysed early childhood weight data using growth mixture modelling, 18‐24 an advanced technique that identifies distinct latent classes of individuals who share similar trajectories 25 . None of these publications included a normal, healthy sample in a high‐income country with body composition outcomes.…”

Section: Introductionmentioning

confidence: 99%

Early childhood weight gain: Latent patterns and body composition outcomes

Norris

Mansukoski

Gilthorpe

et al. 2021

Paediatric Perinatal Epid

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Background Despite early childhood weight gain being a key indicator of obesity risk, we do not have a good understanding of the different patterns that exist. Objectives To identify and characterise distinct groups of children displaying similar early‐life weight trajectories. Methods A growth mixture model captured heterogeneity in weight trajectories between 0 and 60 months in 1390 children in the Avon Longitudinal Study of Parents and Children. Differences between the classes in characteristics and body size/composition at 9 years were investigated. Results The best model had five classes. The “Normal” (45%) and “Normal after initial catch‐down” (24%) classes were close to the 50th centile of a growth standard between 24 and 60 months. The “High‐decreasing” (21%) and “Stable‐high” (7%) classes peaked at the ~91st centile at 12‐18 months, but while the former declined to the ~75th centile and comprised constitutionally big children, the latter did not. The “Rapidly increasing” (3%) class gained weight from below the 50th centile at 4 months to above the 91st centile at 60 months. By 9 years, their mean body mass index (BMI) placed them at the 98th centile. This class was characterised by the highest maternal BMI; highest parity; highest levels of gestational hypertension and diabetes; and the lowest socio‐economic position. At 9 years, the “Rapidly increasing” class was estimated to have 68.2% (95% confidence interval [CI] 48.3, 88.1) more fat mass than the “Normal” class, but only 14.0% (95% CI 9.1, 18.9) more lean mass. Conclusions Criteria used in growth monitoring practice are unlikely to consistently distinguish between the different patterns of weight gain reported here.

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“…2,4,8,9 Similar considerations are also possible for the impaired postnatal growth that has been commonly reported in HEU, with variable consistency of findings. 4,[10][11][12][13][14][15][16][17] Comparative studies in the era of universal and lifelong maternal ART therapy, when mortality is expected to be low, 9 are limited. To contribute to this issue, we designed a longitudinal cohort study of mother-infant pairs with different maternal HIV status, followed for 1 year postnatally in three health facilities in Malawi.…”

Section: Introductionmentioning

confidence: 99%

A 12-month Prospective Study of HIV-infected and HIV-uninfected Women and Their Infants in Malawi: Comparative Analysis of Clinical Events and Infant Growth

Floridia

Orlando

Andreotti

et al. 2023

The American Journal of Tropical Medicine and Hygiene

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Few studies have compared clinical outcomes in HIV-exposed uninfected (HEU) and HIV-unexposed uninfected (HUU) infants in the current scenario of universal and lifelong maternal antiretroviral therapy (ART). HIV-uninfected and HIV-infected Malawian women receiving ART and their breastfed infants were followed for 12 months postpartum, analyzing the rates of infectious and noninfectious events and assessing infant growth at 6 weeks, 6 months, and 12 months. The cohorts included 227 mothers (70 HIV-negative, 157 HIV-positive) and 235 infants (72 HUU, 163 HEU). No maternal or infant deaths occurred during follow-up. HIV-negative women were less likely to complete follow-up (48.6% versus 91.1%). Mothers with and without HIV had similar rates of both infectious and noninfectious events per person-month. Infants who were HEU, compared with HUU, had higher rates of events of any type, lower respiratory tract infections (LRTI), and noninfectious events. HEU had lower body mass index (BMI) at 6 weeks but did not differ from HUU in all anthropometric measures at 6 and 12 months; in growth between 6 weeks and 12 months; and in occurrence of stunting, underweight, and wasting at 6 weeks, 6 months, and 12 months. During the first year of life, infants who were HEU, compared with HUU, showed a transiently lower BMI and an increased risk of LRTI.

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HIV-Exposed, Uninfected Infants in Uganda Experience Poorer Growth and Body Composition Trajectories than HIV-Unexposed Infants

Cited by 13 publications

References 37 publications

Comparison of Feeding Practices and Growth of Urbanized African Infants Aged 6–12 Months Old by Maternal HIV Status in Gauteng Province, South Africa

Comparison of Feeding Practices and Growth of Urbanized African Infants Aged 6–12 Months Old by Maternal HIV Status in Gauteng Province, South Africa

Early childhood weight gain: Latent patterns and body composition outcomes

A 12-month Prospective Study of HIV-infected and HIV-uninfected Women and Their Infants in Malawi: Comparative Analysis of Clinical Events and Infant Growth

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