Browsing by Author "Strydom, Klara"
Now showing 1 - 1 of 1
Results Per Page
Sort Options
- ItemBody composition and nutritional intake of HIV exposed preterm, very- and extremely-low birth weight infants in Tygerberg hospital, Western Cape(Stellenbosch : Stellenbosch University, 2018-12) Strydom, Klara; Van Niekerk, Evette; Dhansay, Muhammed Ali; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Global Health. Human Nutrition.ENGLISH SUMMARY : Introduction: The relationship between HIV exposure and body composition (and the quality thereof) of preterm infants is not well researched. Human breast milk (HBM) is considered inadequate in meeting the protein requirements of very low birth weight (VLBW) infants, which could affect the body composition. Objectives: The primary objective of this study was to determine the body composition of HIV-exposed preterm VLBW and extremely low-birth weight (ELBW) infants. Secondary objectives were to evaluate the effect of the treatment duration of maternal highly active antiretroviral therapy (HAART) and the effect HBM has on the body composition of this vulnerable population. Furthermore, the effect of breast milk fortification and days infants were kept nil per os (NPO) has on body composition were also assessed. Methods: A descriptive cross-sectional study was conducted between May and October 2016. HIV-exposed and -unexposed preterm infants (gestational age < 37 weeks) with a birth weight of ≤1 200 g were included. Each infant’s maternal medical background was recorded. Anthropometric and body composition measurements were recorded weekly during the 28-day follow-up period. Nutritional intakes and clinical progress was documented daily. Results: A total of 113 preterm infants were included in this study, of which thirty infants (27%) were HIV-exposed. HIV-exposed infants had significantly (𝑝= 0.01) lower gestational ages than HIV-unexposed infants (25–28 weeks). HIV-exposed infants displayed significantly lower fat mass percentage (FM%) on day 21 and day 28 (0.9% vs. 1.4%, 𝑝= 0.02 and 1.0% vs. 1.5%; 𝑝= 0.03), respectively. HIV-exposed infants whose mothers received HAART for ≥ 20 weeks had higher weights and FM% with lower fat-free mass percentages (FFM%) at birth when compared to infants whose mothers received treatment for shorter durations (≥ 4–< 20 weeks). In this study 110 of 113 preterm infants received HBM, of which 91 infants received fortified HBM. HIV-exposed and unexposed infants receiving fortified HBM displayed differences in (FM%) (0.88% vs. 1.36%; 𝑝=0.01) compared to (0.97% vs.1.49%; 𝑝= 0.03) and FFM% (98.98% vs. 98.68%; 𝑝= 0.03) compared to (99.02% vs. 98.49%; 𝑝= 0.02), on day 21 and 28 respectively. All Infants kept NPO vs. not kept NPO displayed differences in FM% on day 7, 21 and 28 of life (0.9% vs 1.3%; 𝑝= 0.03), (0.99% vs 1.4%; 𝑝= 0.02) and (0.9% vs 1.6%; 𝑝= 0.0004) as well as differences in FFM% (99.1% vs 98.4%; 𝑝= 0.0005) on day 28 of life. Conclusion: Body composition differs between HIV-exposed and HIV-unexposed preterm infants and the duration of maternal HAART affects postnatal infant body composition. There were no significant differences in the body composition of HIV-exposed and HIV-unexposed infants who received HBM or fortified HBM. However, between the HIV-exposed infants significant differences in body composition measurements were found for infants who received fortified HBM and those who did not. Infants who were kept NPO were generally smaller, shorter, and had lower FM% and more FFM%. Key Message: The ward feeding protocols for preterm infants should be re-evaluated, focusing specifically on the HIV-exposed preterm infants, to improve short and long term outcomes of this vulnerable population.