Neurodevelopmental outcomes and in-utero antiretroviral exposure in HIV-exposed uninfected children.
AIDS
; 32(17): 2583-2592, 2018 11 13.
Article
em En
| MEDLINE
| ID: mdl-30134292
ABSTRACT
OBJECTIVES:
To assess and compare neurodevelopmental disorders in HIV-exposed uninfected (HEU) and HIV-unexposed uninfected (HUU) children in British Columbia, Canada. To determine associations between these outcomes and in-utero exposure to antiretroviral drugs.DESIGN:
Retrospective controlled cohort study.METHODS:
Data were collected on 446 HEU children and 1323 HUU children (matched â¼1ââ3 for age, sex, and geocode) born between 1990 and 2012. Multivariable logistic regressions determined odds ratios of neurodevelopmental disorder diagnoses.RESULTS:
HEUs had three times higher odds of being born preterm (Pâ<â0.0001), and a more than two-fold increase in odds for autism, disturbance of emotions, hyperkinetic syndrome, and developmental delay compared with matched HUUs (Pâ<â0.02) in unadjusted analysis. This association was reduced [adjusted neurodevelopmental disorder odds ratio (AOR)â=â1.67; 95% confidence interval 1.12-2.48; Pâ=â0.011] after adjusting for maternal substance use and/or smoking (children born after April 2000). Regardless of antiretroviral exposure type (i.e. none, treatment with one or multiple drug classes), HEUs had higher odds of any neurodevelopmental disorders compared with matched HUUs; however, there was no evidence suggesting any specific classes of antiretroviral drugs or exposure durations increased their likelihood of neurodevelopmental disorders.CONCLUSION:
The results suggest no adverse associations between antiretroviral drugs and neurodevelopmental disorders within antiretroviral-exposed HEU children in our cohort. Prevalence of neurodevelopmental disorders is higher in HEUs; however, maternal substance use plays a role, as could other environmental factors not captured. These findings highlight a need for holistic support for pregnant women as well as careful developmental monitoring of HEUs past infancy, and access to early interventions, particularly among those born preterm and those exposed to addictive substances.
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
2_ODS3
Base de dados:
MEDLINE
Assunto principal:
Efeitos Tardios da Exposição Pré-Natal
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Desenvolvimento Infantil
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Antirretrovirais
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Transtornos do Neurodesenvolvimento
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Troca Materno-Fetal
Tipo de estudo:
Observational_studies
/
Prevalence_studies
/
Risk_factors_studies
Limite:
Adolescent
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Child
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Child, preschool
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Female
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Humans
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Infant
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Male
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Newborn
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Pregnancy
País/Região como assunto:
America do norte
Idioma:
En
Revista:
AIDS
Ano de publicação:
2018
Tipo de documento:
Article