Open AccessEvaluating mild cachexia syndrome in the HIV-positive pregnant woman
Author(s) -
Amanda L. Wilkinson,
Sarah Pedersen,
Urassa Mark,
Denna Michael,
Anne Helms Andreasen,
Jim Todd,
Safari Kinung’hi,
John Chen,
Joann M. McDermid
Publication year - 2019
Publication title -
african journal of midwifery and women's health
Language(s) - English
Resource type - Journals
eISSN - 2052-4293
pISSN - 1759-7374
DOI - 10.12968/ajmw.2018.0015
Subject(s) - medicine , cachexia , anthropometry , birth weight , low birth weight , pediatrics , pregnancy , immunology , obstetrics , cancer , biology , genetics
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.