Evaluating mild cachexia syndrome in the HIV-positive pregnant woman. (2nd October 2019)

• Record Type: Journal Article
• Authors: Wilkinson, Amanda L.; Pedersen, Sarah H.; Mark, Urassa; Denna, Michael; Aura, Andreasen; Jim, Todd; Kinung'hi, Safari M.; John, Changalucha; McDermid, Joann M.
• Is Part Of: African journal of midwifery and women's health. Volume 13:Number 4(2019)
• Page Start: 1
• Page End: 13
• Publication Date: 2019-10-02
• Subjects: HIV -- Cachexia -- Infant growth -- Pregnancy -- Inflammation; Midwifery -- Periodicals; Midwifery -- Africa -- Periodicals; Obstetrics -- Periodicals; Obstetrics -- Africa -- Periodicals; Women -- Health and hygiene -- Periodicals; Women -- Health and hygiene -- Africa -- Periodicals; 618.20096
• DOI: 10.12968/ajmw.2018.0015
• Languages: English
• ISSNs: 1759-7374

Abstract

Abstract : Background: Immune activation and inflammation are common symptoms throughout HIV infection and lead to elevated circulating concentrations of cachectic cytokines. Aims: To evaluate cachexia-like symptoms among HIV-positive and HIV-negative pregnant women, and investigate whether cachexic mechanisms may contribute to impaired HIV-exposed fetal and infant growth. Methods: Pregnant women ( n =114; 39% HIV-positive) were prospectively enrolled from an antenatal clinic in semi-rural Tanzania. Maternal cachexia-associated plasma cytokines and hormones, and clinical and anthropometric data were assessed. Cachexia scores were quantified using a novel adaptation of a validated cachexia scoring system. Infant growth anthropometry was measured at birth and after 6 months. Results: Maternal cachexia score was inversely associated with infant birth weight, birth length, and weight-for-age z-score at 6 months. Conclusions: Symptoms consistent with a mild cachectic state were associated with poorer infant outcomes. This effect was greater for HIV-exposed infants. A better understanding of the maternal cachexia burden and implications for maternal and infant health in HIV, other infections, and inflammatory conditions is needed.