Morbidity and undernutrition are associated with impaired neurodevelopment among HIV‐exposed infants in Tanzania

Abstract

ObjectiveTo identify maternal, socioeconomic (SES), and child predictors of neurodevelopmental status among 311 Tanzanian infants born to HIV‐infected women.MethodsMaternal and SES data were recorded during pregnancy, HIV status was assessed at 6 weeks then every 3 months, morbidity and anthropometrics were assessed monthly, and the Bayley Scales of Infant Development‐II were administered at 6, 12, and 18 months.Results10.3% of infants were HIV‐positive at 6 wks. Mean Psychomotor Development Index (PDI) and Mental Development Index (MDI) scores were 94.0 ± 14.7 and 93.6 ± 16.1, respectively. In multivariate analyses, having ≥ 3 episodes of cough and fever, stunting, or underweight lowered PDI scores by 5.82 (95% CI −9.89, −1.74), 6.26 (−11.22, −1.18), and 6.33 (−11.03, −1.63) and MDI scores by 8.77 (−12.37, −5.16), 4.78 (−8.99, −0.57), and 6.43 (−11.27, −1.60), respectively. Mean PDI scores were higher among infants whose mothers had elevated depressive symptoms, preterm and HIV‐negative infants; MDI scores were higher among infants whose mothers had a low mid‐upper arm circumference, those born preterm, with a low birthweight, low vitamin B12 levels, and few episodes of diarrhea.ConclusionsPreventing and treating child illnesses and undernutrition could improve the neurodevelopment of HIV‐exposed infants.Grant Funding Source : NICHD