Associations of maternal HIV infection, anaemia and placental insufficiency with neurodevelopment and anaemia in South African children: a cross-sectional study

Objective: To determine associations between maternal anaemia and child neurodevelopment and anaemia among 18-month-old children exposed to maternal HIV infection and placental insufficiency.Design: A cross-sectional study was conducted. Placental insufficiency was detected by an abnormal umbilical...

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Main Authors: Mothusi Nyofane, Marinel Hoffman, Helen Mulol, Qondeni Ndlangamandla, Robert Pattinson, Ute Feucht
Format: Article
Language:English
Published: Taylor & Francis Group 2025-08-01
Series:The South African Journal of Clinical Nutrition
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Online Access:https://www.tandfonline.com/doi/10.1080/16070658.2025.2538402
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author Mothusi Nyofane
Marinel Hoffman
Helen Mulol
Qondeni Ndlangamandla
Robert Pattinson
Ute Feucht
author_facet Mothusi Nyofane
Marinel Hoffman
Helen Mulol
Qondeni Ndlangamandla
Robert Pattinson
Ute Feucht
author_sort Mothusi Nyofane
collection DOAJ
description Objective: To determine associations between maternal anaemia and child neurodevelopment and anaemia among 18-month-old children exposed to maternal HIV infection and placental insufficiency.Design: A cross-sectional study was conducted. Placental insufficiency was detected by an abnormal umbilical artery resistance index (UmA-RI) on Doppler ultrasound during gestation.Setting: Kalafong Provincial Tertiary Hospital.Subjects: In total, 260 mother–child pairs grouped into HIV-unexposed-uninfected children (CHUU): n = 198 vs. HIV-exposed-uninfected children (CHEU): n = 62, and normal UmA-RI (N-RI): n = 225 vs. abnormal UmA-RI (AbN-RI): n = 35 were investigated. Also, CHUU/N-RI (control): n = 178 was compared with CHEU/AbN-RI (dual exposure): n = 15.Outcome measures: Haemoglobin concentrations were tested using the HemoCue® Hb 201+. Bayley-III assessed children’s cognitive, motor, and language development at the corrected age.Results: More than one-third of children across the groups were mildly anaemic. Some 25.7% of mothers in AbN-RI group were mildly anaemic, significantly more than the N-RI mothers (9.8%); p = 0.027. In the CHEU group, maternal haemoglobin concentrations were associated with child haemoglobin concentrations: β = 0.19, 95% confidence interval (CI) (0.02,0.36); p = 0.028. The AbN-RI group had significantly lower mean cognitive composite scores compared with the N-RI group: 96.4 ± 12.2 vs. 100.0 ± 10.5; p = 0.017. Significantly lower mean cognitive scores were observed in CHEU/AbN-RI compared with CHUU/N-RI: 93.9 ± 12.9 vs. 100.0 ± 10.6; p < 0.001. There was no evidence to suggest an association between haemoglobin concentration and child neurodevelopment; however, in CHEU, cognitive development was associated with LAZ: β = 3.34, 95% CI (1.13,5.54), p = 0.004.Conclusions: Child health and nutrition-sensitive programmes need to prioritize CHEU and children with placental insufficiency as at-risk groups for cognitive delays.
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series The South African Journal of Clinical Nutrition
spelling doaj-art-13b115d1cc5c477d924b3b6d71cde8dc2025-08-21T14:01:31ZengTaylor & Francis GroupThe South African Journal of Clinical Nutrition1607-06582221-12682025-08-011910.1080/16070658.2025.2538402Associations of maternal HIV infection, anaemia and placental insufficiency with neurodevelopment and anaemia in South African children: a cross-sectional studyMothusi Nyofane0Marinel Hoffman1Helen Mulol2Qondeni Ndlangamandla3Robert Pattinson4Ute Feucht5Department of Consumer and Food Sciences, University of Pretoria, Pretoria, South AfricaDepartment of Consumer and Food Sciences, University of Pretoria, Pretoria, South AfricaResearch Centre for Maternal, Fetal, Newborn and Child Health Care Strategies, University of Pretoria, Kalafong Provincial Tertiary Hospital, Pretoria, South AfricaBiostatistics Research Unit, South African Medical Research Council, Pretoria, South AfricaResearch Centre for Maternal, Fetal, Newborn and Child Health Care Strategies, University of Pretoria, Kalafong Provincial Tertiary Hospital, Pretoria, South AfricaResearch Centre for Maternal, Fetal, Newborn and Child Health Care Strategies, University of Pretoria, Kalafong Provincial Tertiary Hospital, Pretoria, South AfricaObjective: To determine associations between maternal anaemia and child neurodevelopment and anaemia among 18-month-old children exposed to maternal HIV infection and placental insufficiency.Design: A cross-sectional study was conducted. Placental insufficiency was detected by an abnormal umbilical artery resistance index (UmA-RI) on Doppler ultrasound during gestation.Setting: Kalafong Provincial Tertiary Hospital.Subjects: In total, 260 mother–child pairs grouped into HIV-unexposed-uninfected children (CHUU): n = 198 vs. HIV-exposed-uninfected children (CHEU): n = 62, and normal UmA-RI (N-RI): n = 225 vs. abnormal UmA-RI (AbN-RI): n = 35 were investigated. Also, CHUU/N-RI (control): n = 178 was compared with CHEU/AbN-RI (dual exposure): n = 15.Outcome measures: Haemoglobin concentrations were tested using the HemoCue® Hb 201+. Bayley-III assessed children’s cognitive, motor, and language development at the corrected age.Results: More than one-third of children across the groups were mildly anaemic. Some 25.7% of mothers in AbN-RI group were mildly anaemic, significantly more than the N-RI mothers (9.8%); p = 0.027. In the CHEU group, maternal haemoglobin concentrations were associated with child haemoglobin concentrations: β = 0.19, 95% confidence interval (CI) (0.02,0.36); p = 0.028. The AbN-RI group had significantly lower mean cognitive composite scores compared with the N-RI group: 96.4 ± 12.2 vs. 100.0 ± 10.5; p = 0.017. Significantly lower mean cognitive scores were observed in CHEU/AbN-RI compared with CHUU/N-RI: 93.9 ± 12.9 vs. 100.0 ± 10.6; p < 0.001. There was no evidence to suggest an association between haemoglobin concentration and child neurodevelopment; however, in CHEU, cognitive development was associated with LAZ: β = 3.34, 95% CI (1.13,5.54), p = 0.004.Conclusions: Child health and nutrition-sensitive programmes need to prioritize CHEU and children with placental insufficiency as at-risk groups for cognitive delays.https://www.tandfonline.com/doi/10.1080/16070658.2025.2538402maternal HIV-exposureanaemiaplacental insufficiencyneurodevelopment
spellingShingle Mothusi Nyofane
Marinel Hoffman
Helen Mulol
Qondeni Ndlangamandla
Robert Pattinson
Ute Feucht
Associations of maternal HIV infection, anaemia and placental insufficiency with neurodevelopment and anaemia in South African children: a cross-sectional study
The South African Journal of Clinical Nutrition
maternal HIV-exposure
anaemia
placental insufficiency
neurodevelopment
title Associations of maternal HIV infection, anaemia and placental insufficiency with neurodevelopment and anaemia in South African children: a cross-sectional study
title_full Associations of maternal HIV infection, anaemia and placental insufficiency with neurodevelopment and anaemia in South African children: a cross-sectional study
title_fullStr Associations of maternal HIV infection, anaemia and placental insufficiency with neurodevelopment and anaemia in South African children: a cross-sectional study
title_full_unstemmed Associations of maternal HIV infection, anaemia and placental insufficiency with neurodevelopment and anaemia in South African children: a cross-sectional study
title_short Associations of maternal HIV infection, anaemia and placental insufficiency with neurodevelopment and anaemia in South African children: a cross-sectional study
title_sort associations of maternal hiv infection anaemia and placental insufficiency with neurodevelopment and anaemia in south african children a cross sectional study
topic maternal HIV-exposure
anaemia
placental insufficiency
neurodevelopment
url https://www.tandfonline.com/doi/10.1080/16070658.2025.2538402
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