Predictors of hemoglobin at age 6 weeks among infants born to HIV‐infected mothers in Tanzania

Abstract

OBJECTIVETo identify maternal, environmental, and neonatal predictors of hemoglobin (Hb) concentration and anemia among infants born to women with HIV infection.METHODS: Among 2276 infants enrolled in a randomized trial of micronutrient supplementation, maternal socioeconomic and nutritional data were recorded during pregnancy, and Hb and HIV status were assessed at 6 wks. Multivariable regression models were created to identify predictors of infant Hb and anemia (Hb < 9.0 g/dL) at postnatal age 6 weeks.RESULTS: 29.4% of mothers had CD4 T‐cell count < 350 cells/μL, and 27.2% met criteria for WHO HIV Stages II–IV. 7% of infants had birthweight < 2500 g. At age 6 weeks, 11.3% were HIV‐infected, and 13.0% had CD4 T‐cell % < 25. Mean Hb was 10.3 g/dL, and 16.6% had anemia. Independent predictors of lower Hb at age 6 weeks included lower daily family food expenditure, lower maternal CD4 count, maternal ARV use, lower birthweight, and higher weight‐for‐length Z‐score. Independent predictors of Hb < 9.0 g/dL included lower daily family food expenditure, lower maternal Hb, lower maternal CD4 count, lower birthweight, and lower infant CD4%.CONCLUSIONS: Poverty, maternal HIV severity, lower maternal Hb, lower birthweight, and infant HIV severity were all associated with anemia at age 6 weeks in HIV‐exposed infants. Infants with these risk factors should be screened for anemia and treated appropriately.