Background Human immunodeficiency virus (HIV) sero-prevalence rate during pregnancy was 26% in 2009 in Gauteng. HIV exposure is associated with high morbidity and mortality in infants. Few studies have assessed the effect of HIV exposure on morbidity and mortality in very low birth weight (VLBW) infants. Aim To determine the infant characteristics at birth, morbidity during hospital stay and mortality at hospital discharge of VLBW infants according to maternal HIV status. Methods This was a retrospective cross sectional descriptive study. Hospital records of VLBW infants admitted at the Chris Hani Baragwanath Academic Hospital, Division of Neonatology from 1st January 2011 to 30th June 2011 were reviewed. Data were collected in an Excel spread sheet and imported to STATA version 12 for analysis. Results 302 hospital records of VLBW infants admitted from January to June 2011 were retrieved and reviewed. About a third (34.1%) of VLBW infants were born to mothers who were HIV positive. There were more babies who weighed <1000 grams in the HIV-exposed infants compared to HIV-unexposed infants (p-0.001). HIV exposed infants had a smaller head circumference (p-0.003), a shorter body length (p-0.006) and significantly more severe grades of IVH (p <0.001) compared to HIV unexposed infants. The overall mortality rate in VLBW infants was 27%, with HIV exposed infants having a mortality rate of 38.6% compared to 21% in the HIV-negative infants (p-0.002). Multivariate analysis showed that the main predictor of mortality was birth weight (p<0.001). Conclusion Though on univariate analysis maternal HIV status was associated with mortality in VLBW infants, this effect was not found on multivariate analysis. Therefore the final conclusion from this study is that maternal HIV status has no independent effect on outcomes to hospital discharge in VLBW infants. Birth weight was the predictor of survival in VLBW infants.

In 2008, 1.8 million children under the age of 15 were living with HIV/AIDS in sub-Saharan Africa. The same report estimates that in 2008, there were 390 000 new infections in children below the age of 15 in Sub- Saharan Africa. Children appear to be the generation most affected by the HIV/AIDS epidemic. With the introduction of Highly Active Antiretroviral therapy (HAART) more perinatally infected children are living into adolescence and beyond. They will have to learn to live with a stigmatising, potentially fatal chronic illness. Health care workers can no longer rely solely on traditionally used outcome measures, such as viral loads and CD4+ percentages, to monitor effectiveness of interventions and treatments. Quality of Life (QoL) has been suggested as an additional essential outcome measure in clinical practice and research involving children living with a chronic illness. In this research the concept of Health Related Quality of Life (HRQoL) is evaluated in HIV-infected children using the PedsQL 4.0 Generic Core Scale (child self-reports, ages five-seven). The PedsQL 4.0 Generic Core Scales has been found to be a valid and reliable HRQoL measurement tool in children with chronic diseases, school-going children and children infected with HIV. Domains of Physical, Emotional, Social and School Functioning were evaluated. The children in the comparison group scored significantly higher (p<0.01) indicating a better quality of life. The HIV-infected children scored significantly lower in all four domains, with Physical Functioning being most affected (p<0.01). The children with HIV were found to be shorter (p<0.01) and lighter (p<0.01) than those in the comparison group. This could be a contributing factor to the physical difficulties experienced by the HIV-infected children. No relationship could be established between total scores of HRQoL and CD4+ percentages, viral load and duration of HAART treatment. Demographic data collected indicate that the HIV-infected children were more likely to have a primary caregiver with a lower level of education (p=0.01) and more likely to be receiving a Dependency Care Grant (p=0.05). The HRQoL results of this study are similar to those conducted in other parts of the world. The results stress the need for a multi-disciplinary approach when treating HIV-infected children. It has become essential to focus on the medical, physical and psychosocial functioning of the HIV-infected child thereby promoting participation in the family, school and the broader community.

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Our naïve theory of social behavior assumes that the positive and negative actions of others are caused by some underlying social disposition. Furthermore, adults automatically infer such traits in advance based upon whatever observable, even superficial, properties are available (e.g., how someone looks or sounds). The goal of the current study is to explore the developmental origins of this bias. We tested whether 12-month-old infants automatically infer a character’s social disposition (i.e., whether they ‘help’ or ‘hinder’ another character’s goal) based upon the superficial properties they display. Infants were habituated to two characters that possessed surface properties that were rated either more positively (a soft, fluffy appearance and a happy-sounding laugh) or more negatively (a sharp, pointy appearance and a deep, ominous laugh) by adults. We then observed whether babies showed more visual interest in the characters that engaged in social actions that were inconsistent rather than consistent with their appearance. A control condition helped determine whether any observed looking differences were based upon infants inferring a causal relationship between surface property and disposition or a non-causal association between positive and negative characteristics. Results from these two studies showed that infants are able to use an agent’s superficial properties in determining that agent’s future behavior.

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Fetal Movement (FM) has been studied as a prenatal manifestation of activity level, a core dimension of many temperament theories. However, there has been little research exploring the significance of variability in the pattern of FM. The current study uses hierarchical linear modeling to compute the developmental function of FM in the third trimester. This study also examined how variability in the pattern of FM, in contrast to mean FM, predicted infant development. The following hypotheses were tested: 1. Mean FM will predict infant development at 3 and 6 months; 2. The developmental function of FM will display an inverted-U shape with significant variability; and 3. The pattern of FM will predict infant outcome at 3 and 6 months. Thirty-three mothers were asked to provide weekly counts of FM. Infant temperament, mental development, and motor development were assessed at 3 and 6 months. The best-fitting pattern describing FM was a piecewise linear function with FM increasing until 34 weeks gestation and thereafter decreasing, but variability was noted. The overall mean FM and pattern of FM were differentially associated with infant development. Higher mean FM was associated with increases in negative affect and decreases in orienting/regulation across 3 to 6 months. Mean FM also predicted infant size. The pattern of FM was related to different outcome variables. Increases in FM early and decreases in FM late in the third trimester were associated with less activity and greater emotional tone and attention at 3 months. This same pattern of FM was related to weighing more at 6 months, decreasing in extraversion from 3 to 6 months, and becoming more active from 3 to 6 months of age. The results indicate that the pattern of FM provides information about subsequent development that is different from mean FM. Whereas mean FM was associated with aspects of difficult temperament, the pattern of FM predicted more positive outcomes. These findings suggest that the pattern of FM may be useful as a prenatal assessment of postnatal development.

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