Abstract
BackgroundThere is growing concern about the developmental outcome of infants exposed to HIV in utero. HIV-infected women are at greater risk of premature delivery which poses a further developmental risk factor.ObjectivesTo determine whether there is a difference between the development of premature infants born at 28–37 weeks gestational age that are HIV exposed but uninfected (HEU) compared with HIV-unexposed uninfected infants (HUU).MethodA cross-sectional study was conducted in a Johannesburg state hospital. Thirty HEU and 30 HUU infants, aged between 16 days and six months, were assessed using the Bayley Scales of Infant and Toddler Development III.ResultsThe two groups were well matched for gestational age and birth weight; however, more HUU infants presented with neonatal complications. HUU infants had lower developmental scores than HEU infants in the language (p = 0.003) and motor (p = 0.037) subscales. Expressive language was more affected in the HUU infants (p = 0.001), and fine (p = 0.001) and gross motor (p = 0.03) were affected as well. HUU infants with neonatal complications such as meningitis (p = 0.02) and neonatal jaundice (NNJ) (p = 0.01) are more likely to present with language and motor delay.ConclusionMeningitis and NNJ have more impact on infant development than in-utero HIV and ARV exposure.Clinical implicationsIt is important for all premature infants to be screened regularly in order to diagnose developmental delays early so as to ensure early intervention and improved quality of life.
Highlights
South Africa is responsible for 70% of all new human immunodeficiency virus (HIV) infections globally (UNAIDS 2013)
The majority of infants were born with an low birth weights (LBW) (67%) and there was no significant difference between the two groups for birth weight categories (p = 0.50)
A significant difference (p = 0.02) was seen in the number of infants who had a history of meningitis, with more HIV-unexposed uninfected (HUU) infants affected
Summary
South Africa is responsible for 70% of all new human immunodeficiency virus (HIV) infections globally (UNAIDS 2013). Human immunodeficiency virus-positive women who are not on antiretrovirals (ARVs) may transmit the infection to their babies during the in utero and intrapartum periods as well as postpartum through breastfeeding (Hilburn, Potterton & Stewart 2010). The incidence of preterm birth varies from one community to another and depends on a number of factors (Castell et al 2013). HIV-infected women are at greater risk of premature delivery which poses a further developmental risk factor
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