Children exposed to HIV in utero are at risk of adverse growth outcomes, even if they do not acquire HIV perinatally. Some growth impacts begin before birth, with children exposed to HIV being more likely to be born preterm and small for gestational age, as well as with low birthweight. Children born with HIV (CHIV) exhibit more growth differences than children exposed to HIV in utero but born uninfected (CHEU); although, early treatment with antiretroviral therapy significantly improves their growth outcomes. CHEU are also vulnerable to poor growth postnatally. The causes are multifaceted and include increased susceptibility to infection and socioeconomic vulnerabilities. Pediatricians must be aware of the unique growth vulnerabilities of CHIV and CHEU, so they can carefully follow growth while assessing potential drivers of growth disparities for each child to help ensure that they achieve their full growth potential.

Disclosure: KJN has received research funds from the Society of General Internal Medicine Lawrence S. Linn Research Grant, paid to the institution; is an independent study monitor for a National Institute of Health-funded project by Weill Cornell Medicine; and has received support for travel from City-MatCH Taskforce. EDL has received support from NIH R01, Women's Committee of the Children's Hospital of Philadelphia (CHOP), and Penn Global Engagement Funds, paid to the institution; is a speaker for the University of Pittsburgh and MidAtlantic AIDS Education Training Center; has received support for travel from CityMatCH Taskforce and the Birth and Breastfeeding Conference; and has a spouse who is an employee of Otsuka Pharmaceuticals.