Intrauterine HIV exposure is associated with linear growth restriction among Ethiopian children in the first 18 months of life
(2022) In Tropical Medicine and International Health 27(9). p.823-830- Abstract
Objective: The role of HIV exposure in determining growth among HIV-uninfected children is debated. We determined whether intrauterine HIV exposure influences linear growth in a cohort of Ethiopian children followed up to 18 months of age in public health facilities in Adama city, Ethiopia. Methods: Participants were offspring of pregnant women enrolled in a prospective cohort study that included screening for HIV infection during antenatal care. Growth patterns of HIV-exposed and uninfected (HEU) and HIV-unexposed (HU) children were compared up to 18 months of age, with length-for-age z-score (LAZ) and proportion with stunting as primary outcomes. Multivariable linear and logistic regression models were constructed to investigate the... (More)
Objective: The role of HIV exposure in determining growth among HIV-uninfected children is debated. We determined whether intrauterine HIV exposure influences linear growth in a cohort of Ethiopian children followed up to 18 months of age in public health facilities in Adama city, Ethiopia. Methods: Participants were offspring of pregnant women enrolled in a prospective cohort study that included screening for HIV infection during antenatal care. Growth patterns of HIV-exposed and uninfected (HEU) and HIV-unexposed (HU) children were compared up to 18 months of age, with length-for-age z-score (LAZ) and proportion with stunting as primary outcomes. Multivariable linear and logistic regression models were constructed to investigate the associations between HIV exposure and linear growth, controlling for socio-demographic factors and breastfeeding status. Results: Of 1705 included infants (164 HEU), 1276 remained in follow-up at 18 months. Among HIV-positive mothers, 132 (80.5%) were receiving antiretroviral therapy at enrolment. At the 18-month visit, mean LAZ was −1.08 among HEU children and −0.74 among HU children (p = 0.052). Proportions of HEU and HU children with stunting at the 18-month visit were 27.8% and 18.7%, respectively (p = 0.010). In multivariable models, HIV exposure was associated with lower LAZ at all follow-up visits, and with stunting at the 18-month visit (adjusted odds ratio 2.29, 95% confidence interval 1.40–3.71). HIV exposure was not associated with weight-related growth outcomes. Conclusions: HEU children in Ethiopia had inferior linear growth compared with HU children, implying that intrauterine HIV exposure impacts early childhood growth in this setting.
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- author
- Szanyi, Joshua LU ; Walles, John König LU ; Tesfaye, Fregenet LU ; Gudeta, Adugna Negussie LU and Björkman, Per LU
- organization
- publishing date
- 2022
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- child, growth, HIV, length, nutrition, stunting, uninfected
- in
- Tropical Medicine and International Health
- volume
- 27
- issue
- 9
- pages
- 823 - 830
- publisher
- Wiley-Blackwell
- external identifiers
-
- pmid:36075687
- scopus:85136238293
- ISSN
- 1360-2276
- DOI
- 10.1111/tmi.13805
- language
- English
- LU publication?
- yes
- id
- c8b5c83c-961c-4c56-a887-f941244db199
- date added to LUP
- 2022-09-12 14:44:43
- date last changed
- 2024-09-20 04:26:33
@article{c8b5c83c-961c-4c56-a887-f941244db199, abstract = {{<p>Objective: The role of HIV exposure in determining growth among HIV-uninfected children is debated. We determined whether intrauterine HIV exposure influences linear growth in a cohort of Ethiopian children followed up to 18 months of age in public health facilities in Adama city, Ethiopia. Methods: Participants were offspring of pregnant women enrolled in a prospective cohort study that included screening for HIV infection during antenatal care. Growth patterns of HIV-exposed and uninfected (HEU) and HIV-unexposed (HU) children were compared up to 18 months of age, with length-for-age z-score (LAZ) and proportion with stunting as primary outcomes. Multivariable linear and logistic regression models were constructed to investigate the associations between HIV exposure and linear growth, controlling for socio-demographic factors and breastfeeding status. Results: Of 1705 included infants (164 HEU), 1276 remained in follow-up at 18 months. Among HIV-positive mothers, 132 (80.5%) were receiving antiretroviral therapy at enrolment. At the 18-month visit, mean LAZ was −1.08 among HEU children and −0.74 among HU children (p = 0.052). Proportions of HEU and HU children with stunting at the 18-month visit were 27.8% and 18.7%, respectively (p = 0.010). In multivariable models, HIV exposure was associated with lower LAZ at all follow-up visits, and with stunting at the 18-month visit (adjusted odds ratio 2.29, 95% confidence interval 1.40–3.71). HIV exposure was not associated with weight-related growth outcomes. Conclusions: HEU children in Ethiopia had inferior linear growth compared with HU children, implying that intrauterine HIV exposure impacts early childhood growth in this setting.</p>}}, author = {{Szanyi, Joshua and Walles, John König and Tesfaye, Fregenet and Gudeta, Adugna Negussie and Björkman, Per}}, issn = {{1360-2276}}, keywords = {{child; growth; HIV; length; nutrition; stunting; uninfected}}, language = {{eng}}, number = {{9}}, pages = {{823--830}}, publisher = {{Wiley-Blackwell}}, series = {{Tropical Medicine and International Health}}, title = {{Intrauterine HIV exposure is associated with linear growth restriction among Ethiopian children in the first 18 months of life}}, url = {{http://dx.doi.org/10.1111/tmi.13805}}, doi = {{10.1111/tmi.13805}}, volume = {{27}}, year = {{2022}}, }