Makasa M, Kasonka L, Chisenga M, Sinkala M, Chintu C, Tomkins A, Filteau S
Lusaka District Health Management Team, Lusaka, Zambia.
Trop Med Int Health. 2007 May;12(5):594-602. doi: 10.1111/j.1365-3156.2007.01836.x.
Parental HIV infection may affect even those exposed children who remain uninfected. We investigated early growth, an indicator of overall health, of infants born to Zambian mothers recruited for a study of breastfeeding and postpartum health.
HIV-infected and uninfected women in Lusaka were followed regularly from late pregnancy to 16 weeks postpartum. Infant weight and length were measured at birth, 6 and 16 weeks. Infant HIV status could not be specifically determined in this cohort so comparisons were between all infants of HIV-uninfected mothers (n = 184) and those infants of HIV-infected mothers who were known to be alive and showed no clinical evidence of HIV infection at age 2-4 years (n = 85).
Most infants were exclusively or predominantly breastfed until 16 weeks. At all time points infants of HIV-infected mothers tended to have lower weight and length standard deviation (Z) scores (significant for weight at 6 weeks; P = 0.04), even after adjustment for their lower gestational age at birth, compared with infants of uninfected mothers. In multivariate analyses the major factors affecting weight or length at 6 or 16 weeks of age were birth weight or length, and maternal subclinical mastitis, primiparity and weight during pregnancy.
Early growth of infants of HIV-infected mothers is less than that of uninfected mothers, in part associated with subclinical mastitis, and this effect cannot be overcome with intensive support of mothers to follow international recommendations regarding exclusive breastfeeding.
父母感染艾滋病毒甚至可能会影响那些未被感染的暴露儿童。我们对赞比亚母亲所生婴儿的早期生长情况进行了调查，早期生长是整体健康状况的一个指标，这些母亲被招募来参与一项关于母乳喂养和产后健康的研究。
卢萨卡的感染艾滋病毒和未感染艾滋病毒的妇女从妊娠晚期到产后16周接受定期随访。在出生时、6周和16周时测量婴儿的体重和身长。在这个队列中无法具体确定婴儿的艾滋病毒感染状况，因此比较的是未感染艾滋病毒母亲的所有婴儿（n = 184）与那些已知存活且在2至4岁时无艾滋病毒感染临床证据的感染艾滋病毒母亲的婴儿（n = 85）。
大多数婴儿在16周前完全或主要进行母乳喂养。在所有时间点，感染艾滋病毒母亲的婴儿体重和身长标准差（Z）得分往往较低（6周时体重差异显著；P = 0.04），即使在对其出生时较低的孕周进行调整后，与未感染母亲的婴儿相比也是如此。在多变量分析中，影响6周或16周龄体重或身长的主要因素是出生体重或身长、母亲的亚临床乳腺炎、初产和孕期体重。
感染艾滋病毒母亲的婴儿早期生长情况不如未感染母亲的婴儿，部分原因与亚临床乳腺炎有关，并且即使在大力支持母亲遵循关于纯母乳喂养的国际建议时，这种影响也无法克服。
