Maternal HIV infection and other factors associated with growth outcomes of HIV-uninfected infants in Entebbe, Uganda

Objective To assess the associations between maternal HIV infection and growth outcomes of HIV-exposed but uninfected infants and to identify other predictors for poor growth among this population. Design Within a trial of de-worming during pregnancy, the cohort of offspring was followed from birth. HIV status of the mothers and their children was investigated and growth data for children were obtained at age 1 year. Length-for-age, weight-for-age and weight-for-length Z-scores were calculated for each child; Z-scores <-2 were defined as stunting, underweight and wasting, respectively. Setting The study was conducted in Entebbe municipality and Katabi sub-county, Uganda. Subjects The sample consisted of 1502 children aged 1 year: HIV-unexposed (n 1380) and HIV-exposed not infected (n 122). Results Prevalence of stunting, underweight and wasting was 14 center dot 2 %, 8 center dot 0 % and 3 center dot 9 %, respectively. There was evidence for an association between maternal HIV infection and odds of being underweight (adjusted OR = 2 center dot 32; 95 % CI 1 center dot 32, 4 center dot 09; P = 0 center dot 006) but no evidence for an association with stunting or with wasting. Young maternal age, low maternal education, low birth weight, early weaning and experiencing a higher number of episodes of malaria during infancy were independent predictors for stunting and underweight. A higher number of living children in the family was associated with wasting. Conclusions Maternal HIV infection was associated with being underweight in HIV-exposed uninfected infants. The success of programmes for prevention of mother-to-child HIV transmission means that an increasing number of infants will be born to HIV-infected women without acquiring HIV. Therefore, viable nutritional interventions need to be identified for this population.