Abstract:
Studies investigating the predictors of growth in infants born to HIV-infected women in developing
countries are limited. Using data from 886 Tanzanian HIV-infected women and their infants, we
examined the impact of maternal socioeconomic and immunological status, infant characteristics at
birth, and HIV, diarrhea and respiratory infections on infants’ monthly length-for-age (LAZ) and
length-for-weight (WLZ) z-scores during the first 2 years of life. We used restricted cubic splines to
estimate average adjusted growth curves by categories of each predictor. LAZ decreased significantly
during the first 2 years. WLZ increased from birth to 4 months but decreased significantly thereafter.
Greater maternal schooling significantly reduced deterioration in LAZ and WLZ scores from birth to
24 months, while maternal CD4 cell counts 200mm23 at baseline were associated with reduced
deterioration in LAZ scores. Infants born pre-term or with low-birth weight were significantly more
stunted and wasted than their reference groups at all time points though their rate of growth faltering
was slower. Infant-HIV status was strongly associated with significantly greater deterioration in LAZ
and WLZ scores, beginning at about 4 months of age. Episodes of diarrhea or respiratory infections
were related to significantly lower WLZ but not LAZ scores, independent of infant-HIV status.
In conclusion, maternal schooling, immunological status and infant infections are important predictors
of early growth in children born to HIV-positive women.
