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Neurodevelopment of HIV-Exposed and HIV-Unexposed Uninfected Children at 24 Months
- Publication Year :
- 2017
- Publisher :
- American Academy of Pediatrics, 2017.
-
Abstract
- BACKGROUND:We sought to determine if HIV-exposed uninfected (HEU) children had worse neurodevelopmental outcomes at 24 months compared with HIV-unexposed uninfected (HUU) children in Botswana.METHODS:HIV-infected and uninfected mothers enrolled in a prospective observational study (“Tshipidi”) in Botswana from May 2010 to July 2012. Child neurodevelopment was assessed at 24 months with the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III: cognitive, gross motor, fine motor, expressive language, and receptive language domains) and the Development Milestones Checklist (DMC), a caregiver-completed questionnaire (locomotor, fine motor, language and personal-social domains). We used linear regression models to estimate the association of in-utero HIV exposure with neurodevelopment, adjusting for socioeconomic and maternal health characteristics.RESULTS:We evaluated 670 children (313 HEU, 357 HUU) with ≥1 valid Bayley-III domain assessed and 723 children (337 HEU, 386 HUU) with a DMC. Among the 337 HEU children with either assessment, 122 (36%) were exposed in utero to maternal 3-drug antiretroviral treatment and 214 (64%) to zidovudine. Almost all HUU children (99.5%) breastfed, compared with only 9% of HEU children. No domain score was significantly lower among HEU children in adjusted analyses. Bayley-III cognitive and DMC personal-social domain scores were significantly higher in HEU children than in HUU children, but differences were small.CONCLUSIONS:HEU children performed equally well on neurodevelopmental assessments at 24 months of age compared with HUU children. Given the global expansion of the HEU population, results suggesting no adverse impact of in-utero HIV and antiretroviral exposure on early neurodevelopment are reassuring.
- Subjects :
- Male
Pediatrics
medicine.medical_specialty
Anti-HIV Agents
Gross motor skill
Population
HIV Infections
Neuropsychological Tests
Bayley Scales of Infant Development
Article
03 medical and health sciences
0302 clinical medicine
Child Development
Pregnancy
030225 pediatrics
Medicine
Humans
030212 general & internal medicine
Prospective Studies
Toddler
Pregnancy Complications, Infectious
education
Prospective cohort study
education.field_of_study
Botswana
business.industry
medicine.disease
Child development
Breast Feeding
Case-Control Studies
Child, Preschool
Prenatal Exposure Delayed Effects
Pediatrics, Perinatology and Child Health
Linear Models
Female
business
Breast feeding
Follow-Up Studies
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....f45f31a38334f9cdba716bc087ac2ccf