Directed acyclic graph
We constructed a directed acyclic graph using DAGitty to examine for possible confounding in the relationship between HIV and ART exposure and child developmental performance on the Bayley Scales of Infant and Toddler Development, third edition, at 6 months and 24 months in the Drakenstein Child Health Study, using multiple sources.3, 10, 11, 12 In this model, site acts as a proxy for home language and ethnicity. Maternal psychosocial factors include maternal depression, alcohol use, and smoking. Minimal sufficient adjustment sets for estimating the total effect of maternal HIV and ART exposure on child neurodevelopment include socioeconomic status (household income), maternal education, and maternal age. ART=antiretroviral therapy.