Browsing by Author "Lodewyks, Thea"
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- ItemGrowth and nutritional intake of HIV exposed preterm very low and extremely low birth weight infants at Tygerberg Hospital, Western Cape, South Africa(Stellenbosch : Stellenbosch University, 2018-03) Lodewyks, Thea; Van Niekerk, Evette; Dhansay, Ali; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Global Health. Human Nutrition.ENGLISH SUMMARY: Introduction: There is a gap in research in the South African context regarding the relationship between preterm infants, HIV, nutritional interventions and growth. Determining the growth of HIV-exposed preterm infants would create a better understanding of the adverse effects of this infectious disease on the nutritional status of preterm infants, their growth and future outcomes. It would also assist in implementing timely and appropriate interventions. Objectives: This study aimed to determine the growth and nutritional intake of HIV-exposed and HIV-unexposed preterm, very low birth weight (VLBW) infants at Tygerberg Hospital, Western Cape, South Africa. Study objectives included evaluating and comparing the effect of nutritional intake and the duration of maternal highly active antiretroviral therapy (HAART) on the growth of preterm, VLBW infants. Participants and methods: The study was a descriptive cross-sectional study with an analytical component. Neonatal wards at Tygerberg Children’s Hospital (TBCH) were selected for data collection. The study population consisted of male and female preterm and very low birth weight HIV-exposed and HIV-unexposed infants. Infants with a birth weight of < 1 200 g were eligible for the study. Anthropometrical measurements, daily intakes, and feeding tolerance were monitored for 28 days. Results: Of the 113 infants enrolled in the study, 26.5% (n = 30) were HIV-exposed and 73.5% (n = 83) were HIV-unexposed. The mean birth weight was 971.06 g (± 162.92 g). The HIV-unexposed preterm infants had a higher mean birth weight than the HIV-exposed group, although the difference was not significant. The two groups gained weight at a similar rate until day 14 of life, whereafter the HIV-unexposed group gained weight at a higher rate. The same trend was observed in head circumference growth. The HIV-unexposed group had significantly greater birth lengths (p = 0.016) when compared with the HIV-exposed group, but weekly follow-up measurements did not differ significantly until day 28 of life (p = 0.004). Full feeds were achieved on day 12.5 (± 3.71) and day 11.37 (± 3.31) of life for the HIV-exposed and unexposed groups respectively, but the difference was not significant. This study found that there was no correlation between the duration of maternal HAART and gestational age (r = 0.06), birth weight (r = 0.08) or foot length (r = 0.09). A weak positive correlation existed between the duration of maternal HAART and the infant’s birth length (r = 0.17) and head circumference (r = 0.25). There were no differences in the incidence of signs of feeding intolerance between the groups. Conclusion: HIV exposure influences the growth of premature infants, irrespective of nutritional intake. The growth rates of HIV-exposed infants were lower for all anthropometric parameters.