THE EFFECTS OF HIV ON COGNITIVE AND MOTOR DEVELOPMENT IN CHILDREN BORN TO HIV-SEROPOSITIVE WOMEN WITH NO REPORTED DRUG-USE - BIRTH TO 24 MONTHS

Objective. This study documents delays in the mental and motor functio ning of infants perinatally infected with human immunodeficiency virus (HIV) while controlling for confounding effects of prenatal drug expo sure, ethnicity, socioeconomic status, and maternal separation and dea th. Methods. The cognitive and motor development of 126 infants born t o nondrug-using, HIV-seropositive Haitian women was assessed at S-mont h intervals through 24 months of age using the Bayley Scales of Infant Development. By 18 months of age, 28 of the infants were diagnosed as HIV-infected, and the 98 uninfected infants served as a control group . The infected and uninfected infants did not differ with respect to m ean gestational age, birth weight, ethnicity, or rates of maternal sep aration and death. Results. By 3 months of age, the mean mental and mo tor scores of the infected infants were significantly lower than those of the uninfected controls. Furthermore, the initial differences betw een the two groups increased over time, as many of the infected infant s became increasingly delayed. Although the infected infants tended to perform more poorly than the uninfected infants, nearly one third of the infected infants exhibited relatively normal cognitive development and half demonstrated relatively normal motor development. Conclusion s. Over the first 24 months of life, the mean rate of development of H IV-infected infants is significantly slower than that of noninfected i nfants horn to seropositive mothers. This occurs even when the effects are not confounded with those of prenatal drug exposure.