INTRAUTERINE AND POSTNATAL-GROWTH IN CHILDREN BORN TO WOMEN INFECTED WITH HIV

The objective of the current study was to assess intrauterine growth ( as determined by weight, length, and head circumference at birth) and postnatal growth patterns (through 36 months of age) of children with transplacentally acquired human immunodeficiency virus type 1 (HIV-1) infection. To accomplish this end, a retrospective chart review was un dertaken for all infants born to HIV-1-positive women who were being f ollowed as of July 1990 in three hospitals in Los Angeles County. The resulting cohort consisted of 53 infants of whom 21 were Hispanic, 13 were Black, 9 were Caucasian, and 10 were of mixed ethnicity. Twenty-s even infants remained HIV-1-positive and 26 infants were uninfected wi th seroreversion after age 15 months. In HIV-1-infected infants, the m edian age of shifting from asymptomatic (P1) to symptomatic (P2) disea se was 15.9 +/- 5.8 (SE) months. Mean standard deviation score (SDS) f or birthweight was significantly less in infants who were HIV-1-positi ve [-0.7 +/- 1.6 (SD)] than in those who were uninfected (-0.1 +/- 1.1 ) (p = 0.04), with no difference in prevalence of prematurity. There w ere no differences in either mean length or mean head circumference at birth between the two groups. Mean postnatal weight, length, and head circumference were significantly less in HIV-1-positive infants than in uninfected infants at multiple time points during the first 36 mont hs of life. We conclude that HIV-1 infection in infants may have profo und effects on pre- and postnatal growth. Infants born to mothers with HIV-I infection who themselves were infected had lower mean birth wei ght than infants who seroreverted; however, because of considerable ov erlap between groups, birthweight was not a useful predictor of ultima te HIV-1 status. Most of the observed postnatal growth delay occurred in HIV-1-infected infants who, during the first 3 years of life, shift ed from an asymptomatic to a symptomatic state, although not soon afte r birth. In addition, there were no changes in any postnatal growth pa rameter that predicted the age of shift from asymptomatic to symptomat ic HIV-1 infection.