Maternal HIV infection, drug use, and growth of uninfected children in their first 3 years.
OBJECTIVE
To determine the separate effects of maternal HIV infection and drug use during pregnancy on growth of uninfected children in their first 3 years.


METHODS
Retrospective analysis of measurements from health visitor records made during routine child health surveillance at 6 weeks, 10 months, and 3 years of age. Multilevel analysis allowed for between-infant variation in fitted growth lines, and adjustment for other factors. Growth was described in terms of an intercept (z score at term) and growth slopes (change in z score per year) up to, and from, 4 months.


METHODS
290 case babies delivered in Edinburgh hospitals to women who reported injection drug use by either themselves or their HIV infected partner, and 186 community controls. A total of 131 (45%) of the case babies were born to women who used drugs, predominantly opiates, during pregnancy and 93 (32%) to HIV infected women. The eight infected children were excluded from analysis.


METHODS
Age and sex standardised z scores for height, weight, and body mass index.


RESULTS
459 (96%) of the 476 records for cases and controls were traced, yielding 1432 weight and 939 height measurements. Maternal HIV infection was not found to affect growth; at 3 years the estimated effect on weight z score was 0.16 with 95% confidence interval (-0.25 to 0.57) and for height 0.18 (-0.19 to 0.55). Drug use during pregnancy was associated with lighter babies at 40 weeks followed by depressed growth in the first four months, these infants remaining just slightly smaller at 3 years with an estimated effect on z scores of -0.5 for weight with 95% confidence interval (-0.89 to -0.11) and -0.37 (-0.72 to -0.02) for height.


CONCLUSIONS
Maternal HIV infection does not adversely affect growth in uninfected infants, and the effect of drug use during pregnancy is limited to small decrease in size at 3 years.
MRC Biostatistics Initiative for AIDS and HIV in Scotland, Centre for HIV Research, Edinburgh.
A
A
Ross
G M
GM
Raab
J
J
Mok
S
S
Gilkison
B
B
Hamilton
F D
FD
Johnstone
D001827:Body Height; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D006128:Growth; D015658:HIV Infections; D006801:Humans; D007223:Infant; D008297:Male; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious; D011297:Prenatal Exposure Delayed Effects; D012189:Retrospective Studies; D019966:Substance-Related Disorders; D015430:Weight Gain