TABLE 1.
Maternal and child characteristics by HIV infection and exposure status
| Total (N=869) | HIV-positive mothers and HEU infants (n=459) | HIV-negative mothers and HU infants (n=410) | p-value | |
|---|---|---|---|---|
| Maternal/household characteristics at first antenatal visit | ||||
| Age in years | 28 (24; 32) | 28 (24; 32) | 27 (23; 32) | 0·11 |
| Married/cohabiting | 372 (43%) | 188 (41%) | 184 (45%) | 0·24 |
| Completed secondary education | 297 (34%) | 113 (25%) | 184 (45%) | <0·0001 |
| Employed | 376 (43%) | 182 (40%) | 194 (47%) | 0·023 |
| Formal housing | 432 (50%) | 218 (47%) | 214 (52%) | 0·17 |
| Flush toilet inside home | 290 (33%) | 125 (27%) | 165 (40%) | <0·0001 |
| Running water inside home | 402 (46%) | 188 (41%) | 214 (52%) | 0·001 |
| Household crowding (≥10 people) | 40 (5%) | 28 (6%) | 12 (3%) | 0·026 |
| Poverty category1 | 0·036 | |||
| Least disadvantaged | 259 (30%) | 145 (32%) | 114 (28%) | |
| Moderate disadvantage | 334 (38%) | 158 (34%) | 176 (43%) | |
| Most disadvantaged | 276 (32%) | 156 (34%) | 120 (29%) | |
| Risky drinking2 | 146 (17%) | 116 (25%) | 30 (7%) | <0·0001 |
| Intimate partner violence 3 | 133 (15%) | 101 (22%) | 32 (8%) | <0·0001 |
| Depression4 | 74 (9%) | 46 (10%) | 28 (7%) | 0·089 |
| Season/time of year5 | 0·12 | |||
| Warm months (Spring/Summer) | 457 (53%) | 230 (50%) | 227 (55%) | |
| Cold months (Autumn/Winter) | 412 (47%) | 229 (50%) | 183 (45%) | |
| Timing of HIV diagnosis | - | |||
| Prior to current pregnancy | - | 197 (43%) | - | |
| During current pregnancy | - | 262 (57%) | - | |
| HIV viral load at ART initiation (log10 copies/mL) | - | 4·0 (3·3–4·5) | - | - |
| CD4 cell count at ART initiation (cells/mm3)6 | - | 354 (248–528) | - | - |
| CD4 cell count > 350 cells/mm3 | - | 231 (52%) | - | - |
| Gestational age at ART initiation (weeks)7 | - | 22 (17–28) | - | - |
| ART initiated < 24 weeks | - | 277 (61%) | - | - |
| Birth and infant characteristics | ||||
| Duration of ART use in pregnancy (weeks) 7 | - | 16·7 (11·1–21·7) | - | - |
| HIV viral load at time of delivery (log10 copies/mL) | - | 1·59 (1·59–1·64) | - | - |
| Maternal viral suppression achieved by time of delivery (HIV viral load <50 copies/mL) | - | 108 (23%) | - | - |
| Season/time of year, at birth5 | <0·0001 | |||
| Warm months (Spring/Summer) | 426 (49%) | 255 (56%) | 171 (42%) | |
| Cold months (Autumn/Winter) | 443 (51%) | 204 (44%) | 239 (58%) | |
| Place of delivery | 0·016 | |||
| Primary care | 344 (39%) | 181 (39%) | 163 (40%) | |
| Hospital care | 512 (59%) | 266 (58%) | 246 (60%) | |
| Born before arrival | 13 (2%) | 12 (3%) | 1 (<1%) | |
| Gestational age at delivery (weeks) | 39 (38–40) | 39 (38–40) | 39 (38–40) | 0·42 |
| Preterm birth (<37) | 93 (11%) | 55 (12%) | 38 (9%) | 0·20 |
| Weight-for-age Z-score at birth | −0·13 (−0·84; 0·50) | −0·21 (−0·94; 0·37) | −0·05 (−0·71; 0·64) | 0·001 |
| Small-for-gestational-age8 (SGA, birthweight <10th centile) | 90 (10%) | 51 (11%) | 39 (10%) | 0·44 |
| Categories of preterm and SGA | ||||
| AGA, term | 695 (80%) | 358 (78%) | 337 (82%) | 0·47 |
| AGA, preterm | 84 (10%) | 50 (11%) | 34 (8%) | |
| SGA, term | 81 (9%) | 46 (10%) | 35 (9%) | |
| SGA, preterm | 9 (1%) | 5 (1%) | 4 (1%) | |
| Weight at birth (kg) | 3·18 (2·82–3·46) | 3·13 (2·76–3·40) | 3·22 (2·86–3·51) | 0·0003 |
| Low birth weight (<2500g) | 97 (11%) | 61 (13%) | 36 (9%) | 0·035 |
| Very low birth weight (<1500g) | 9 (1%) | 5 (1%) | 4 (1%) | 0·87 |
| Male sex | 426 (49%) | 230 (50%) | 196 (48%) | 0·50 |
| Early initiation of breastfeeding (EIBF, within 1 hour of birth) | 786 (91%) | 399 (87%) | 387 (95%) | <0·0001 |
| Ever exclusively breastfed (EBF)9 | 781 (86%) | 419 (91%) | 332 (81%) | <0·0001 |
| Duration of EBF (months)9 | 1·4 (0·2–3·1) | 1·5 (0·3–5·3) | 1·4 (0·2–3·0) | 0·0066 |
| Duration of any breastfeeding (months) | 6·0 (1·5–12·0) | 3·9 (1·4–12·0) | 9·0 (3·0–12·0) | 0·0001 |
| Optimal breastfeeding: Early initiation, exclusively breastfed for ≥5 months and breastfed throughout follow-up9 | 122 (14%) | 80 (17%) | 42 (10%) | 0·002 |
| Postnatal characteristics | ||||
| Maternal depression at 6 weeks’ postnatal visit10 | 30 (4%) | 19 (4%) | 11 (3%) | 0·24 |
| Ever received co-trimoxazole preventive therapy11 | - | 237 (69%) | - | - |
| Any cigarette smoking in the home (maternal or others) 12 |
296 (36%) | 187 (43%) | 109 (27%) | <0·0001 |
| Household energy sources ever included biomass fuel or paraffin13 | 208 (25%) | 180 (42%) | 28 (7%) | <0·0001 |
| Season/ time of year, 3 months of age5 | 0·83 | |||
| Warm months (Spring/Summer) | 406 (47%) | 216 (47%) | 190 (46%) | |
| Cold months (Autumn/Winter) | 463 (53%) | 243 (53%) | 220 (54%) | |
HEU, all HIV-exposed uninfected infants followed postnatally (n=2 infants not included in further analysis); HU, all HIV-unexposed uninfected infants followed postnatally (n=1 child excluded from further analysis); CD, cluster of differentiation; SD, standard deviation; Results are n (column %) with p-value from chi2 test; median (interquartile range, IQR) with p-value from Kruskal-Wallis
Composite indicator based on standardized asset score (includes running water and flush toilet as assets) and employment
Risky drinking, defined as Alcohol use disorders identification test (AUDIT-C) score ≥3 as reported at first antenatal visit (missing data, n=2)
Any physical, sexual or psychological violence as measured with World Health Organization violence against women questionnaire at first antenatal visit (missing data, n=4)
Maternal depression, EPDS (Edinburgh postnatal depression scale) score of ≥ 13 at first antenatal visit (missing data, n=2)
Seasons defined as: Spring, 01 September to 30 November; Summer, 01 December to 28/29 February; Autumn, 01 March to 31 May; Winter, 01 June to 31 August
Missing data, n=12
Missing data, n=3
Birth weight percentile based on Intergrowth-21st reference standards, AGA defined as ≥10th centile
Maternal report (24 hour recall); exclusive breastfeeding defined as only breastmilk and prescribed medicine; duration of EBF excludes those who never exclusively breastfed; for calculation of “optimal breastfeeding” practices, exclusive breastfeeding for 5 months presumed if EBF reported at last attended follow-up visit prior to 5 months
Maternal depression, EPDS (Edinburgh postnatal depression scale) score of ≥ 13 at 6 weeks’ postnatal visit (missing data, n=51)
Maternal report at 6 weeks’ and/or 3 months’ study visit: infant receipt of co-trimoxazole preventive therapy (missing data, n=114)
Maternal report at 6 weeks, 6 or 12 months’ study visit: any household members smoking
Maternal report at 6 weeks, 6 or 12 months’ study visit: biomass fuel defined as burning of wood or charcoal in the home (missing data, n=38)