Neurodevelopmental Outcomes

Abstract

ABSTRACT Background. Neurodevelopmental impairment (NI) is a serious problem because it not only affects the individual s quality of life but it also decreases the future s human resources for the entire society. Early detection and intervention greatly decrease the above risks. There is limited data on infant neurodevelopmental outcomes in Tanzania. Aim. To document the neurodevelopmental (ND) outcomes in a cohort of infants aged 3 12 months born to mothers with known HIV status. Methods. A total of 1873 infants were assessed at 3, 6, 9 and 12 months using the Bayley Infant Neurodevelopmental Screener (BINS). Infants were assigned low, moderate or high risk status depending on their raw scores at the respective ages. Multivariate regression analysis was used to determine the predictors for poor neurodevelopmental outcomes Results. The prevalence of high risk of ND impairment among the infants screened was 6.2% (116/1873). The rates were highest at 6 and 9 months. Maternal HIV infection (OR = 3.2, CI = 1.89 5.34) and twins (OR = 3.8, CI = 1.74 8.58) were significantly associated with high risk of ND impairment. Infants with high risk outcome were more likely to die than those with low to moderate risk of NI. Educational level, body mass index, age of the mother, marital status, prenatal alcohol intake and birth weight did not predict ND outcomes. Both groups of infants born to HIV infected mothers {infected; N = 11, discordant; N = 80} had poorer ND outcomes than infants born to HIV uninfected mothers {controls; N = 1745}. Conclusion. Neurodevelopmental impairment is a problem in infants in this setting. Maternal HIV infection and twins contribute to the high rate of poor ND outcomes seen in this cohort. In addition to the biological risk of HIV, there are other factors contributing to poor ND outcomes in uninfected infants born to HIV infected mothers.