Study On The Growth Status And Its Influencing Factors Of Children Born To HIV Positive Mothers

Background AIDS is still a major public health problem and social problem facing the world.With the implementation of Mother to Child Transmission Program(MTCT)and the continuous maturity of technology,more and more HIV-infected women choose to give birth.The children born to these women are quite special.The group was exposed to HIV virus and antiviral drugs during the fetal period.In the neonatal period,the antiviral drugs are continued to be taken prophylactically.How do their growth and development levels compared with normal infants and young children.The growth and development of HEU children deserves high attention.Objective Understand the growth and development levels of children born to HIV-infected mothers,evaluate their nutritional and intelligent development,and further explore the factors affected growth and development of these children.Method Current survey method was used in this study.208 infants and young children born to HIV-infected mothers born in Guangxi from March 2016to January 2019 were selected as special exposure groups by the special population,and were drawn in the same period in a 1:1ratio,infants born to non-HIV-infected mothers were the control group.The self-made questionnaire and standardized psychological scale were used to investigate the basic situation of infants and their parents.At the same time,the body weight,body length,head circumference and bust circumference of the two groups were measured.The intelligent development level of infants and young children was measured by Denver Development Test(DDST).The physical development levels of the two groups were evaluated using the Chinese nine-city standard and the WHO physical development criteria.The WHO physical development criteria was used to evaluate physical development levels of the two groups.The low-weight,growth retardation,weight loss,normal intelligent development,and abnormal detection rate were used to describe the nutritional status and intelligent development of the subjects.Single-sample and multi-sample measurement data were analyzed by single-sample T test and independent sample T test.The comparison of the two groups or two groups was analyzed by chi-square test;the multivariate analysis of measurement data was linear regression.For analysis,the count data were analyzed by binary logistic regression.Results1.Birth weight and length:The average birth weight of infants in the exposed group is lower than the WHO standard.The boy was born to reach the WHO physical development standards.The girl's birth length was slightly higher than the WHO standard.2.Weight:There was no significant difference in weight between infants and children in the control group.Compared with the WHO standard,although the birth weight of boys and girls was lower,but it showed a good catching trend from 1 to 3 months old.At 12 and 18 months of age,weight development showed a downward trend,and the gap became larger as the age of the month increased.3.Length:Compared with the control group,the girl's developmental level was lower at the 12th month of age,and the other months were not statistically different.Compared with the WHO standard,boys and girls developed well at 1,3,and 12 months of age,but 18 At the age of month,they are lower than the standard.4.Head circumference:Compared with the control group,the difference was not statistically significant,but compared with the WHO standard,except for girls 3 months old,the head circumference development of the remaining months was at a lower level.5.Bust circumference:Compared with the control group,the level of chest circumference development was lower at 12 months of age.Compared with the nine-city standard,the development of the chest circumference of the boys at each age was at a lower level;except for the one-month-old,the average development of the chest circumference of the other months was at a lower level.6.Z score of physical development:WAZ,LAZ,HAZ,BAZ,WLZ in the exposed group were-0.95±0.88,-0.96±0.91,-0.86±0.93,-0.78±0.90,-0.58±0.99,respectively.LAZ(-0.96±0.91)in the exposed group was slightly lower than that in the control group(-0.75±0.84),t=-2.477,p=0.014;there was no significant difference in the z scores between the remaining physical development indicators.7.Nutritional status:The low body weight rate of children in the exposed group was 10.01%(21/208),the growth retardation rate was 14.42%(30/208),the wasting rate was 3.85%(8/208),and the growth retardation rate(14.42%)of the exposed group was higher than the control group(6.74%),?~2=6.506,p=0.011;the difference between the low body weight rate and the wasting rate were not statistically significant.8.Intelligent development:The normal rate of intelligent development was65.54%(116/177),the suspicious rate was 15.25%(27/177),and the abnormal rate was 19.21%(34/177).The test results were positive(suspicious-abnormal)rate of 34.46%,which was higher than the control group(24.29%),?~2=4.411,p=0.036.9.The results of single factor analysis:(1)Z scores of physical development index:premature birth,low birth weight,added food supplement,1 child in the family,living in other cities/counties in the province,rural household registration,father s'age<35years old,father infected with HIV,mother used The two-way antiviral program during pregnancy and CD4 cell count<200/mm~3 were the influencing factors of the physical development index Z scores.(2)Nutritional status:Premature birth and low birth weight are the influencing factors of low body weight;the age of infants and young children began to add complementary food<4 months old,and mother's nation is Han nationality is the influencing factor of growth retardation.(3)Intelligent development:premature birth,low birth weight,the age of added complementary food<4 months old,mother's birth age?35 years old,rural household registration were the influencing factors of intelligent development.10.Multivariate regression analysis results:(1)Linear regression results of physical development index Z scores showed that low birth weight,HIV pre-pregnancy HIV infection,CD4 cells<200/mm3 were risk factors for WAZ;urban household registration,mothers with anxiety symptoms,and father age?35 years were the protection factor.Premature birth,low birth weight,supplemented food supplements,one child in the family,and other cities/counties living outside Nanning,Guangxi were the risk factors for LAZ;good social support is the protective factor.Low birth weight,father HIV infection,CD4 cells<200/mm~3,and dual antiviral treatment during pregnancy are risk factors for HAZ.Low birth weight and CD4 cells<200/mm~3 are risk factors for BAZ.(2)Logistic regression analysis of nutritional status of infants and young children showed that low birth weight was a risk factor for low body weight during physical development,with an OR value of 6.262(2.348,16.700).Adding complementary foods before 4 months of age,the main caregivers were other people,and the mothers were diagnosed with HIV infection before pregnancy was the risk factor for their growth retardation.The OR values were5.474(1.178,26.110),4.406(1.649,11.773),and 15.011(1.695,132.939),respectively.Cesarean section,Mother's nation was a minority were the protective factors for growth retardation.The OR values were 0.205(0.072,0.582)and 0.334(0.132,0.864),respectively.(3)Logistic regression analysis of infants and young children's intelligent development showed that gender with female,premature birth,and father's antibody of HIV were positive were the risk factors for their intelligent developmental abnormalities.The OR values were 2.210(1.089,20.566)and3.619(1.366,9.589),respectively.2.194(1.071,4.494);complementary food supplements and cesarean delivery were protective factors for intelligent development,with OR values of 0.168(0.066,0.425)and 0.325(0.151,0.698).Conclusion1.Compared with WHO standards,HEU infants had relatively lower levels of physical development.2.The low body weight,growth retardation and weight loss detection rate of HEU infants were 10.01%,14.42%and 3.85%,respectively,which was slightly higher than that of normal infants with malnutrition in the same area.3.The intelligent abnormal rate of infants and young children in HEU was34.46%,slightly higher.4.HIV infection in mothers may be a risk factor for infant growth,growth retardation,and intelligent development.5.The basic situation of infants at birth and the main caregivers and feeding after birth,the general demographic characteristics of the mother and the physical condition during pregnancy,and the HIV infection status of the father affect the growth and development of infants and young children.