Africa Centre for Health and Population Studies, University of KwaZulu-Natal, Mtubatuba, KwaZulu-Natal 3935, South Africa.
AIDS. 2010 Jan 28;24(3):437-45. doi: 10.1097/QAD.0b013e3283345f91.
To examine growth of children by maternal and infant HIV status allowing for infant feeding mode.
Women enrolled into a nonrandomized intervention cohort.
Children of HIV-infected and uninfected women weighed and assessed for HIV status, monthly: from birth to 9 months; quarterly: 10-24 months. Daily infant feeding practices recorded at weekly intervals. Weight-for-age z-scores of children born to HIV-infected mothers compared with the reference population of children of HIV-uninfected mothers. Changes in z-scores over age were examined by HIV infection status and infant feeding practice using linear mixed effects models.
The 1261 children of HIV-infected mothers grew as well as the reference group of 1061 children of HIV-uninfected mothers, irrespective of feeding mode. z-scores for HIV-infected children were consistently lower than those of HIV-exposed but uninfected children: a difference of 420 g for male children and 405 g for female children at 52 weeks of age. Breastfed HIV-infected infants had consistently higher z-scores for weight, especially during first 6 weeks (difference of 130 g for male children; 110 g for female children). In an adjusted regression analysis, maternal mid-upper arm circumference, CD4 cell count, infant birth weight and HIV status had the biggest impact on infant growth (z-score coefficient: 0.38 for mid-upper arm circumference > or =28.35 vs. <25.7 cm; P < 0.001; -0.32 for CD4 cell count <200 vs. > or =500; P = 0.001; -2.01 for birth weight <2500 vs. > or =2500 g; P < 0.001; -0.20 for infected vs. uninfected children; P < 0.001).
Optimal early feeding practices ameliorate the effect of being born to an HIV-infected mother and strengthen the recommendation of exclusive breastfeeding for HIV-infected women in terms of long-term child health.
通过允许婴儿喂养方式，检查母婴 HIV 状况对儿童生长的影响。
参加非随机干预队列的女性。
对感染和未感染 HIV 的妇女的儿童进行称重和 HIV 状况评估，每月：从出生到 9 个月；每季度：10-24 个月。每周间隔记录婴儿喂养方式。将感染 HIV 母亲所生儿童的体重与未感染 HIV 母亲所生儿童的参考人群进行比较。通过线性混合效应模型，根据 HIV 感染状况和婴儿喂养方式，检查年龄变化时 z 分数的变化。
无论喂养方式如何，1261 名感染 HIV 母亲所生的儿童与 1061 名未感染 HIV 母亲所生的儿童一样健康成长。感染 HIV 儿童的 z 分数始终低于 HIV 暴露但未感染儿童：52 周龄时，男童和女童分别相差 420 克和 405 克。母乳喂养的 HIV 感染婴儿的体重 z 分数始终较高，尤其是在前 6 周（男童相差 130 克；女童相差 110 克）。在调整后的回归分析中，母亲的中上臂围、CD4 细胞计数、婴儿出生体重和 HIV 状况对婴儿生长的影响最大（z 分数系数：中上臂围>或=28.35 与<25.7 cm 相比，0.38；P < 0.001；CD4 细胞计数<200 与>或=500 相比，-0.32；P = 0.001；出生体重<2500 与>或=2500 g 相比，-2.01；P < 0.001；感染与未感染儿童相比，-0.20；P < 0.001）。
最佳的早期喂养方式可以改善出生于 HIV 感染母亲的影响，并加强对 HIV 感染妇女进行纯母乳喂养的建议，以促进儿童长期健康。
