A description of early neurodevelopment in a cohort of HIV-exposed uninfected children

In Utero HIV Exposure and the Early Nutritional Environment Influence Infant Neurodevelopment: Findings from an Evidenced Review and Meta-Analysis

“…Of the three studies that reported on language outcomes in HEI infant populations, two reported lower scores [36,45] in comparison to HEU, and one reported no differences [43]. Similar scores between HEU and HUU infant groups were reported for language assessments [53,56] with no evidence of language delay for infants who are HEU [54]. One study reported lower scores and higher odds of delayed development in expressive and receptive language domains at 24 months (but not 6 months) among infants who were HEU compared to HUU in unadjusted and adjusted analyses [50].…”

“…HEI often associated with lower scores on measures of motor development in comparison to infants who were HEU (up to 35 months of age [36,40,45,46]) and increased likelihood of motor developmental impairment compared to HEU and HUU infant groups [38]. While some studies suggested that infants who are HEU may also experience poorer motor outcomes in comparison to HUU [41,42], others reported no differences in average motor scores between the two groups [47,49,50,53,56] or evidence of motor delay for infants who are HEU [54,56]. One study reported psychomotor developmental delay in 3.64% of their sample (206 HEU) between birth and 18 months in comparison to a cited population rate of 1.1-2.5% [39].…”

“…For the nine studies that included analyses on early life nutrition-related variables and infant neurodevelopment, cohort characteristics and comparison groups based on nutritional intervention (if relevant) are reported in Figure 2. Within these nine studies, two reported data on longitudinal neurodevelopmental assessments (for cognitive (n = 2), motor (n = 2), and language (n = 1) outcomes) [50,51], and seven reported cross-sectional assessment data (for cognitive (n = 7), motor (n = 7), language (n = 7), and behavioural (n = 3) outcomes) [52][53][54][55][56][57][58]. [34] of studies reporting on neurodevelopmental outcomes in infants in relation to HIV-exposure status.…”

“…Cognitive developmental delay was often more prevalent among infants who were HEU at 12-13 months [49,56] compared to HUU but may not persist to three years of age [53]. One study reported that in comparison to reference norms, a higher proportion of infants who were HEU had average, higher average, and superior performance on measures of cognitive outcomes [54]. Overall, HEU had a medium, negative effect on BSID-III cognitive subscale scores from four studies (seven cohorts; birth to 36 months) in comparison to HUU; however, the effect was not significant (−0.47 (−1.10, 0.15); Figure 4).…”

“…Infants who were HEU were breastfed at lower rates [57] and for shorter durations [50,56]. Some studies report no associations between breastfeeding practices and neurodevelopmental outcomes up to 36 months [50,53,54] or risk of developmental delay at 13 months [56] in infants who were HEU. One study reported that HEU infants who were ever breastfed had higher cognitive and expressive language scores at 24 months when compared to infants who were never breastfed [57].…”