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59 Perinatal Risk Factors and Cognitive Outcomes in Children HIV-Exposed, Uninfected

Published online by Cambridge University Press:  21 December 2023

Leila Kahnami ,
Julia Young ,
Jason Brophy ,
Lena Serghides ,
Ari Bitnun  and
Mary Lou Smith
Leila Kahnami*
Affiliation:
Department of Psychology, The Hospital for Sick Children, Toronto, ON, Canada. Department of Psychology, York University, Toronto, ON, Canada.
Julia Young
Affiliation:
Department of Psychology, The Hospital for Sick Children, Toronto, ON, Canada. Neurosciences and Mental Health Program, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada.
Jason Brophy
Affiliation:
Division of Infectious Diseases, Children’s Hospital of Eastern Ontario, Ottawa, ON, Canada. Department of Pediatrics, University of Ottawa, Ottawa, ON, Canada.
Lena Serghides
Affiliation:
Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada. Department of Immunology and Institute of Medical Sciences, Toronto, ON, Canada.
Ari Bitnun
Affiliation:
Division of Infectious Diseases, The Hospital for Sick Children, Toronto, ON, Canada. Department of Pediatrics, University of Toronto, Toronto, ON, Canada.
Mary Lou Smith
Affiliation:
Department of Psychology, The Hospital for Sick Children, Toronto, ON, Canada. Neurosciences and Mental Health Program, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada. Department of Psychology, University of Toronto Mississauga, Mississauga, ON, Canada
*
Correspondence: Leila Kahnami, Department of Psychology, The Hospital for Sick Children, Toronto, ON, Canada, Department of Psychology, York University, Toronto, ON, Canada Email: [email protected] Email: [email protected]
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Abstract

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Objective:

Children who are HIV-exposed uninfected (CHEU) are at risk of neurodevelopmental impairments due to perinatal HIV and antiretroviral therapy exposure as well as additional health and psychosocial burdens. There is limited understanding of the impact of perinatal risk factors on long-term outcomes of CHEU. The present study investigated the association between perinatal risk factors and the intellectual and language abilities in CHEU and children who are HIV-unexposed uninfected (CHUU).

Participants and Methods:

CHEU and CHUU, 6 to 10 years, of age underwent neurodevelopmental assessments through the Kids Imaging and Neurocognitive Development (KIND) study at the Hospital for Sick Children in Toronto, Canada between January 2020 and August 2022. CHUU were recruited from the community with similar sociodemographic backgrounds based on residential area in Toronto and parental income levels. Measures of Full-Scale IQ (FSIQ), Verbal Comprehension (VCI), Visual Spatial skills (VSI), Fluid Reasoning (FRI), Working Memory (WMI), and Processing Speed (PSI) were evaluated with the Wechsler Intelligence Scale for Children - Fifth Edition. Core Language, Receptive Language, and Expressive Language skills were assessed with the Clinical Evaluation of Language Fundamentals - Fifth Edition. Perinatal risk factors included birthweight, birth complications (e.g., premature rupture of membranes, jaundice, etc.), maternal smoking and alcohol use during pregnancy, and NICU admission. Analyses of variance and chi-square tests were performed to investigate group differences and multiple regression analyses tested the relation between neurodevelopmental measures and birth factors. Significance was held at p <0.05.

Results:

36 CHEU (21 female, 8.74 ±1.56 years) and 26 CHUU (12 female, 8.53 ±1.50 years) children were included. For both groups, mean standardized scores of the cognitive abilities assessed were in the average range. CHEU had significantly lower birth weight than CHUU, but there were no differences between these groups with respect to maternal smoking and alcohol use, birth complications or NICU admission. There were no between group differences identified for the intellectual and language abilities. In the CHEU group, birthweight was significantly associated with lower VCI, WMI, and expressive language. In the CHUU group, prenatal alcohol and smoking exposure was associated with lower VCI scores. Birth complications were associated with lower WMI, PSI, and FSIQ scores.

Conclusions:

In this interim analysis, perinatal risk factors impacted neurodevelopmental outcomes of CHEU and CHUU differently. While the groups did not differ in frequency of birth complications and maternal smoking and alcohol use, these factors negatively impacted aspects of intellectual ability in the CHUU group. CHEU with lower birthweight are at greater risk of working memory and language difficulties, supporting the need for early interventions and close neuropsychological follow-up of this population throughout childhood.

Keywords

HIV/AIDSintellectual functioninglanguage
Type
Poster Session 01: Medical | Neurological Disorders | Neuropsychiatry | Psychopharmacology
Information
Journal of the International Neuropsychological Society , Volume 29 , Supplement s1: Final Program Fifty First Annual Meeting International Neuropsychological Society February 1–4, 2023 San Diego, CA, USA , November 2023 , pp. 55 - 56
Copyright
Copyright © INS. Published by Cambridge University Press, 2023