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- Title
Evaluating mild cachexia syndrome in the HIV-positive pregnant woman.
- Authors
Wilkinson, Amanda L.; Pedersen, Sarah H.; Mark, Urassa; Denna, Michael; Aura, Andreasen; Jim, Todd; Kinung'hi, Safari M.; John, Changalucha; McDermid, Joann M.
- 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.
- Subjects
TANZANIA; HIV infection complications; ANOREXIA nervosa; ANTHROPOMETRY; BIRTH weight; CACHEXIA; CHI-squared test; COMPARATIVE studies; STATISTICAL correlation; CYTOKINES; GROWTH disorders; HORMONES; OUTPATIENT services in hospitals; IMMUNOSUPPRESSION; INFLAMMATION; LONGITUDINAL method; EVALUATION of medical care; METABOLIC disorders; PREGNANCY; PREGNANT women; PRENATAL care; QUALITY of life; QUESTIONNAIRES; STATURE; T-test (Statistics); TUMOR necrosis factors; BODY movement; HIV seroconversion; ARM circumference; DATA analysis software; DESCRIPTIVE statistics; HIV seronegativity; SYMPTOMS
- Publication
African Journal of Midwifery & Women's Health, 2019, Vol 13, Issue 4, p1
- ISSN
1759-7374
- Publication type
Article
- DOI
10.12968/ajmw.2018.0015