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Neurodevelopmental Outcomes of Young Children Born to HIV-Infected Mothers: A Pilot Study
Megan S McHenry1,2, Eren Oyungu3, Ziyi Yang1
1Indiana University School of Medicine, Indianapolis, IN, United States.
Insights
Neurodevelopment in children exposed to HIV (HEU) and HIV-infected (HIV+) children was assessed. Stunting and being left alone were linked to poorer scores, while HIV+ children showed better receptive language.
Area of Science:
- Pediatric Neurodevelopment
- HIV/AIDS Research
- Global Child Health
Background:
- Over 15 million children perinatally exposed but uninfected (HEU) face neurodevelopmental risks.
- Evidence on neurodevelopmental outcomes for HEU children compared to HIV-infected (HIV+) and HIV-unexposed, uninfected (HUU) children is mixed.
- This pilot study investigates neurodevelopmental scores in these three pediatric groups in Kenya.
Purpose of the Study:
- To compare neurodevelopmental scores across HIV-infected (HIV+), perinatally HIV-exposed but uninfected (HEU), and HIV-unexposed, uninfected (HUU) children.
- To identify factors associated with neurodevelopmental outcomes in these groups.
- To explore maternal depressive symptoms in HEU children's mothers.
Main Methods:
- Cross-sectional pilot study of 172 children aged 18-36 months (24 HIV+, 74 HEU, 74 HUU).
- Neurodevelopmental assessment alongside sociodemographic, laboratory, and growth data collection.
- Statistical analysis included descriptive statistics, ANOVA, chi-squared, and adjusted linear regression.
Main Results:
- Mothers of HEU children reported higher depressive symptoms (p < 0.001).
- HIV+ children exhibited higher receptive language scores (p = 0.007) compared to other groups.
- Lower height-for-age z-scores and being left alone were associated with worse neurodevelopmental scores.
Conclusions:
- Childhood stunting, social isolation (left alone >1 hour), and higher socioeconomic status correlated with poorer neurodevelopmental outcomes.
- Maternal depressive symptoms in HEU children require further investigation.
- Neurodevelopmental trajectories in HEU children warrant continued research.
Abstract:
Introduction: Over 15 million children who were exposed to HIV perinatally but uninfected (HEU) are alive globally, and they are faced with multiple risk factors for poor neurodevelopment. While children who are HIV-infected (HIV+) appear to have worse neurodevelopmental scores compared to children unexposed and uninfected with HIV (HUU), the evidence is mixed in children who are HEU. This small descriptive pilot study aimed to compare neurodevelopmental scores of children who are HIV+, HEU, and HUU in Kenya. Methods: This cross-sectional pilot study included children ages 18-36 months who were HIV+, HEU, or HUU. Neurodevelopment was assessed, along with sociodemographic, lab, and growth data. Statistical analysis included descriptive statistics, one-way ANOVA, chi-squared, and adjusted linear regression models. Results: One hundred seventy two were included (n = 24 HIV+; n = 74 HEU; n = 74 HUU). Mothers of children who were HEU experienced more depressive symptoms (p < 0.001). The only neurodevelopmental differences were found among groups was that children who were HIV+ had higher receptive language scores (p = 0.007). Lower height-for-age z-scores and being left home alone were associated with worse neurodevelopmental scores. Conclusions: Being stunted, left completely alone for at least an hour within the last week, and having higher sociodemographic status were associated with worse neurodevelopmental scores. The higher levels of depressive symptoms within mothers of children who are HEU warrants further investigation.
