Predictors of stunting, wasting, and underweight among infants born to HIV‐infected women in Tanzania

Abstract

Objective To identify child, maternal, and socioeconomic (SES) predictors of stunting, wasting, and underweight among 2387 Tanzanian infants born to HIV-infected women using sdNVP. Methods Maternal and SES data were recorded on enrollment, birth data were collected immediately after delivery, HIV test and morbidity history were performed at 6 wks, anthropometrics were measured monthly until age 24 mo. Results The respective prevalence of prematurity (< 37 wks) and low birthweight (LBW) (<2500 g) was 52% and 7%; 12% of infants tested HIV-positive at 6 wks. Median time to first episode of stunting, wasting, and underweight was 26.4, 28.9, and 25.7 wks, respectively. The risk of each outcome was increased among male, premature, and LBW infants. HIV-positive infants were 2.45 (95% CI 2.01, 2.99), 2.42 (1.97, 2.98), and 3.31 (2.74, 4.01) times more likely to become stunted, wasted, and underweight, respectively. Cough and fever predicted wasting, whereas household possessions were inversely associated with stunting and underweight. As maternal education rose from 0 to 1–4, 5–8, and >8 yrs, the respective risk of stunting fell by 5%, 9%, and 34% (p=.01). Conclusions Knowledge that male sex, prematurity, LBW, child HIV infection, and low maternal education are predictors of undernutrition can guide the design and targeting of interventions for HIV-exposed children. Supported by NICHD R01 HD04368801 and K24HD058795 Grant Funding Source: NICHD