LONGITUDINAL ASSESSMENT OF GROWTH IN CHILDREN BORN TO MOTHERS WITH HUMAN-IMMUNODEFICIENCY-VIRUS INFECTION

Objectives: To describe and to evaluate the longitudinal growth of chi ldren born to mothers with human immunodeficiency virus (HIV) infectio n. Design: Measurements of weight, length (measured in infants in a re cumbent position) and height (measured in older children in an upright position), and head circumference were documented and evaluated longi tudinally using generalized estimating equations in a group of childre n born to HN-infected mothers. Children infected with HIV were compare d with uninfected children and with National Center for Health Statist ics standards. Setting: Primary care clinic in an urban hospital devot ed to the medical care of children born to HIV-infected mothers. Patie nts: One hundred nine children born to HIV-infected mothers, 59 HIV-in fected and 50 uninfected, between birth and 70 months of age. Results: The mean birth weights of both groups were below the 50th percentile. While the mean weight-for-age curve of uninfected children attained t he 50th percentile by age 24 months, the mean birth weight-for-age cur ve of HIV-infected children remained below the 50th percentile. Weight gain became significantly different between the two groups by age 36 months. The mean birth length-for-age curves of HIV-infected and uninf ected children was also below the 50th percentile. The mean height-for -age curve of uninfected children attained the 50th percentile by age 40 months, while that of HIV-infected children remained well below the 50th percentile. Linear growth between HIV-infected and uninfected ch ildren diverged earlier than weight, becoming significantly different by age 15 months. Conclusions: Although children born to HIV-infected mothers are born with weight and length below the 50th percentile, uni nfected children catch up, while HIV-infected children remain below th e 50th percentile and experience an earlier and more pronounced decrea se in linear growth (height-for-age) than in weight-for-age.