Quality of Caregiving is Positively Associated With Neurodevelopment During the First Year of Life Among HIV-Exposed Uninfected Children in Uganda.

Journal: Journal of acquired immune deficiency syndromes (1999)

Volume: 77

Issue: 3

Year of Publication: 2019

Affiliated Institutions:  Department of Psychiatry, Michigan State University, East Lansing, MI. Department of Anthropology, Northwestern University, Evanston, IL. Department of Statistics and Probability, Michigan State University, East Lansing, MI. Department of Community Health and Behavioral Sciences, Makerere University School of Public Health, Kampala, Uganda. Department of Nutritional Sciences, University of Texas at Austin, Austin, TX. Department of Psychiatry, Makerere University College of Health Sciences, Kampala, Uganda. Prenatal Nutrition and Psychosocial Health Outcomes (PRENAPS) Uganda, Kampala, Uganda.

Abstract summary 

We sought to evaluate whether maternal characteristics and infant developmental milieu were predictive of early cognitive development in HIV-exposed uninfected (HEU) and HIV-unexposed uninfected (HU) infants in Uganda.Longitudinal pregnancy study.Ugandan women (n = 228) were enrolled into the Postnatal Nutrition and Psychosocial Health Outcomes study with a 2:1 HIV-uninfected: infected ratio. Maternal sociodemographic, perceived social support, and depressive symptomatology were assessed. Infant growth and neurocognitive development were assessed at 6 and 12 months of age using Mullen Scales of Early Learning (MSEL). Caldwell Home Observation for Home Environment was used to gauge caregiving quality. Linear mixed-effects models were built to examine the relationships between maternal and infant characteristics with infant MSEL scores by HIV exposure.Two MSEL measures were available for 215 mother-child dyads: 140 infants (65%) were HIV-uninfected (HU), 57 (27%) were HIV-exposed uninfected (HEU) with mothers reporting antiretroviral therapy, and 18 (8%) were HEU with mothers not reporting antiretroviral therapy. HEU had lower MSEL Composite (β = -3.94, P = 0.03) and Gross Motor scores (β = -3.41, P = 0.01) than HU. Home Observation for Home Environment total score was positively associated with MSEL Composite (β = 0.81, P = 0.01), Receptive Language (β = 0.59, P = 0.001), and Expressive Language (β = 0.64, P = 0.01) scores.HIV exposure is associated with lower infant cognitive development scores. Increasing maternal quality of caregiving may improve early cognitive development.

Authors & Co-authors:  Familiar Itziar I Collins Shalean M SM Sikorskii Alla A Ruisenor-Escudero Horacio H Natamba Barnabas B Bangirana Paul P Widen Elizabeth M EM Achidri Daniel D Achola Harriet H Onen Daniel D Boivin Michael M Young Sera L SL

Study Outcome 

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Statistics
Citations :  Sugandhi N, Rodrigues J, Kim M, Ahmed S, Amzel A, … Tolle M. Children, HIV Exposed Infants: Rethinking care for a lifelong condition. AIDS (London, England) 2013;27(2):S187.
Authors :  12
Identifiers
Doi : 10.1097/QAI.0000000000001599
SSN : 1944-7884
Study Population
Women,Mothers
Mesh Terms
Adult
Other Terms
Study Design
Cross Sectional Study
Study Approach
Country of Study
Uganda
Publication Country
United States