Morbidity and mortality during the first two years of life among uninfected children born to human immunodeficiency virus type 1-infected women: The women and infants transmission study

Mary E. Paul, Caroline J Chantry, Jennifer S. Read, Margaret M. Frederick, Ming Lu, Jane Pitt, Delmyra B. Turpin, Ellen R. Cooper, Edward L. Handelsman

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

Objective: We evaluated morbidity and mortality during the first 2 years of life among children born to human immunodeficiency virus-(HIV) type 1-infected women enrolled in the Women and Infants Transmission Study (WITS) during an 11-year period (1990-2001). Design and Methods: As part of WITS, evaluations were performed at birth and at 1, 2, 4, 6, 9, 12, 18 and 24 months of age. Growth, hospitalization and the incidence of clinical disease were assessed regularly. Results: Data regarding 1118 children born to HIV-infected women (955 HIV-uninfected children and 163 HIV-infected children) were analyzed. Fewer changes in the caretaker of the child and fewer in utero exposures to drugs, tobacco and alcohol occurred in the latter periods of the study (all P values for time trend analyses <0.01). The percentages of HIV-uninfected children with poor weight gain (44 of 767; 5.7%), short stature (32 of 703; 4.5%) and wasting (27 of 792; 3.4%) were higher than expected for the general population. Two or more changes in caretaker were associated with all growth deficiencies except wasting, and fetal exposure to tobacco was associated with height abnormalities. Anemia was common and was associated with receipt of zidovudine prophylaxis. Morbidity and mortality decreased during the study period. For the uninfected children, a decrease in class A events (Kaplan-Meier rates: group 1, 22.3%; group 2, 6.8%; group 3, 4.2%; P < 0.001) and class C events and death (Kaplan-Meier event rates: group 1, 2.0%; group 2, 1.7%; group 3, 0.2%; P = 0.062) during the first 2 years of life account for the differences in the curves over time. Conclusions: During an 11-year period, morbidity and mortality during the first 24 months of life decreased substantially for children born to HIV-infected women.

Original languageEnglish (US)
Pages (from-to)46-56
Number of pages11
JournalPediatric Infectious Disease Journal
Volume24
Issue number1
DOIs
StatePublished - Jan 2005

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HIV-1
Morbidity
Mortality
HIV
Tobacco
Zidovudine
Growth
Weight Gain
Anemia
Hospitalization
Alcohols
Parturition
Incidence
Pharmaceutical Preparations
Population

Keywords

  • Children
  • Human immunodeficiency virus infection
  • Human immunodeficiency virus-uninfected
  • Morbidity

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Microbiology (medical)

Cite this

Morbidity and mortality during the first two years of life among uninfected children born to human immunodeficiency virus type 1-infected women : The women and infants transmission study. / Paul, Mary E.; Chantry, Caroline J; Read, Jennifer S.; Frederick, Margaret M.; Lu, Ming; Pitt, Jane; Turpin, Delmyra B.; Cooper, Ellen R.; Handelsman, Edward L.

In: Pediatric Infectious Disease Journal, Vol. 24, No. 1, 01.2005, p. 46-56.

Research output: Contribution to journalArticle

Paul, Mary E. ; Chantry, Caroline J ; Read, Jennifer S. ; Frederick, Margaret M. ; Lu, Ming ; Pitt, Jane ; Turpin, Delmyra B. ; Cooper, Ellen R. ; Handelsman, Edward L. / Morbidity and mortality during the first two years of life among uninfected children born to human immunodeficiency virus type 1-infected women : The women and infants transmission study. In: Pediatric Infectious Disease Journal. 2005 ; Vol. 24, No. 1. pp. 46-56.
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T2 - The women and infants transmission study

AU - Paul, Mary E.

AU - Chantry, Caroline J

AU - Read, Jennifer S.

AU - Frederick, Margaret M.

AU - Lu, Ming

AU - Pitt, Jane

AU - Turpin, Delmyra B.

AU - Cooper, Ellen R.

AU - Handelsman, Edward L.

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N2 - Objective: We evaluated morbidity and mortality during the first 2 years of life among children born to human immunodeficiency virus-(HIV) type 1-infected women enrolled in the Women and Infants Transmission Study (WITS) during an 11-year period (1990-2001). Design and Methods: As part of WITS, evaluations were performed at birth and at 1, 2, 4, 6, 9, 12, 18 and 24 months of age. Growth, hospitalization and the incidence of clinical disease were assessed regularly. Results: Data regarding 1118 children born to HIV-infected women (955 HIV-uninfected children and 163 HIV-infected children) were analyzed. Fewer changes in the caretaker of the child and fewer in utero exposures to drugs, tobacco and alcohol occurred in the latter periods of the study (all P values for time trend analyses <0.01). The percentages of HIV-uninfected children with poor weight gain (44 of 767; 5.7%), short stature (32 of 703; 4.5%) and wasting (27 of 792; 3.4%) were higher than expected for the general population. Two or more changes in caretaker were associated with all growth deficiencies except wasting, and fetal exposure to tobacco was associated with height abnormalities. Anemia was common and was associated with receipt of zidovudine prophylaxis. Morbidity and mortality decreased during the study period. For the uninfected children, a decrease in class A events (Kaplan-Meier rates: group 1, 22.3%; group 2, 6.8%; group 3, 4.2%; P < 0.001) and class C events and death (Kaplan-Meier event rates: group 1, 2.0%; group 2, 1.7%; group 3, 0.2%; P = 0.062) during the first 2 years of life account for the differences in the curves over time. Conclusions: During an 11-year period, morbidity and mortality during the first 24 months of life decreased substantially for children born to HIV-infected women.

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KW - Human immunodeficiency virus-uninfected

KW - Morbidity

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