Impact of antenatal antiretroviral drug exposure on the growth of children who are HIV-exposed uninfected: the national South African Prevention of Mother to Child Evaluation cohort study

Ramokolo, Vundli; Kuhn, Louise; Lombard, Carl; Jackson, Debra; Goga, Ameena E.

doi:10.1186/s12879-022-07847-9

Table 4 Multivariable generalized estimating equations regression for predictors of weight-for-age Z-scores in HIV exposed uninfected children, 2012–2014, South Africa

From: Impact of antenatal antiretroviral drug exposure on the growth of children who are HIV-exposed uninfected: the national South African Prevention of Mother to Child Evaluation cohort study

Variable	N^b	Model 1^a		Model 2
Variable	N^b	β	95% CI	β	95% CI
ARV group
Pre-conception ART	613	− 0.14	− 0.25; − 0.02	− 0.08	− 0.20; 0.04
Post-conception ART	773	− 0.09	− 0.20; 0.03	− 0.05	− 0.16; 0.06
None	180	− 0.01	− 0.20; 0.20	0.03	− 0.17; 0.22
Newly infected	59	− 0.06	− 0.36; 0.23	− 0.06	− 0.35; 0.23
AZT	871	Ref	–	Ref	–
Age (months)	2492	0.03	0.03; 0.03	0.03	0.03; 0.03
Sex
Male	1272	0.26	0.17; 0.35	0.27	0.18; 0.35
Female	1224	Ref	–	Ref	–
Maternal age (years)
20–35	2040	0.22	− 0.01; 0.44	0.22	0.00; 0.44
35+	349	0.18	− 0.08; 0.44	0.19	− 0.06; 0.44
14–19	107	Ref	–	Ref	–
Maternal education (grade)
7–12	1917	0.26	0.13; 0.39	0.24	0.11; 0.37
12+	100	0.29	0.01; 0.57	0.23	− 0.06; 0.51
≤ 7	479	Ref	–	Ref	–
Delivery mode
C-section	589	0.26	0.05; 0.47	0.24	0.04; 0.45
Vaginal	1902	Ref	–	Ref	–
Maternal TB
Yes	128	− 0.37	− 0.59; − 0.15	− 0.38	− 0.60; − 0.16
No	2358	Ref	–	Ref	–
Place of delivery
Clinic	446	0.02	− 0.10; 0.14	0.04	− 0.08; 0.16
Home	100	− 0.93	− 1.65; − 0.18	− 1.00	− 1.78; − 0.21
Hospital	1950	Ref	–	Ref	–
Birth attendant
Nurse	1690	0.23	0.03; 0.42	0.21	0.02; 0.41
TBA	90	0.63	− 0.13; 1.40	0.68	− 0.15; 1.52
Doctor	716	Ref	–	Ref	–
Food insecurity at 6-weeks
No	2003	0.13	0.01; 0.25	0.09	− 0.03; 0.21
Yes	490	Ref	–	Ref	–
Brick house
Yes	1830	0.08	− 0.03; 0.18	0.06	− 0.05; 0.18
No	666	Ref	–	Ref	–
Flush toilet
Yes	1339	− 0.06	− 0.16; 0.04	0.04	− 0.08; 0.15
No	1157	Ref	–	Ref	–
Electricity
Yes	2348	0.11	− 0.08; 0.29	0.20	0.01; 0.39
No	148	Ref	–	Ref	–
Breastfeeding at 6-weeks
Yes	1647	− 0.22	− 0.32; − 0.12	− 0.15	− 0.25; − 0.05
No	817	Ref	–	Ref	–
Mother employed
Yes	495	0.16	0.04; 0.28	0.16	0.04; 0.28
No	2001	Ref
Province
Free State	256			− 0.51	− 0.71; − 0.30
Gauteng	499			− 0.21	− 0.40; − 0.02
KwaZulu-Natal	418			0.01	− 0.18; 0.20
Limpopo	256			− 0.15	− 0.36; 0.06
Mpumalanga	292			− 0.18	− 0.38; 0.01
Northern Cape	78			− 0.92	− 1.26; − 0.58
North West	214			− 0.39	− 0.61; − 0.16
Western Cape	234			− 0.30	− 0.52; − 0.09
Eastern Cape	249			Ref	–

Model 1 included 2496 HIV exposed uninfected children with 12,109 observations. Thirty children were excluded because they did not have WAZ data
Model 2 included 2496 HIV exposed uninfected children with 12,109 observations. Model included province (geographical location)
^aThe values in the models are Generalized Estimation Equation regression coefficients (95% CI) which describe the mean WAZ. ART: antiretroviral therapy (Maternal ART regimens generally consisted of Tenofovir, Lamivudine or Emtricitabine and Nevirapine); AZT: Azidothymidine; HEU; HIV exposed but uninfected; None: children with no foetal ARV exposure; Ref: Reference category; SD: standard deviation; TBA: traditional birth attendant; WAZ: weight-for-age Z-score. Only variables that had a significant association with WAZ in the bivariate analysis were included the final models. The multivariable model with the lowest quasilikelihood under the independence model criteria (QIC) was selected as the final model
^bCategories for missing data are not shown in the table

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