title: Maternal systemic or cord blood inflammation is associated with birth anthropometry in a Tanzanian prospective cohort.
abstract: HIV infection is associated with chronic systemic inflammation, with or without antiretroviral therapy. Consequences for foetal growth are not understood, particularly in settings where multiple maternal infections and malnutrition are common. The study was designed to examine maternal systemic circulating and umbilical cord blood cytokine concentrations in relation to birth anthropometry in a Tanzanian prospective cohort.
  
  
  
  A 9-plex panel of maternal plasma cytokines in HIV-positive (n = 44) and HIV-negative (n = 70) mothers and the same cytokines in umbilical cord blood collected at delivery was assayed. Linear regression modelled associations between maternal or cord blood cytokines and birth anthropometry.
  
  
  
  Health indicators (haemoglobin, mid-upper-arm circumference, body mass index) in HIV-positive mothers without considerable immunosuppression did not differ from HIV-negative women. Despite this, HIV-exposed infants had lower birthweight and length. Subgroup analyses indicated that HIV management using HAART was associated with lower plasma TNF-α, as were longer durations of any antiretroviral therapy (≥2 months). Greater maternal plasma TNF-α was associated with earlier delivery (-1.7 weeks, P = 0.039) and lower birthweights (-287 g; P = 0.020), while greater umbilical cord TNF-α (-1.43 cm; P = 0.036) and IL-12p70 (-2.4 cm; P = 0.008) were associated with shorter birth length. Birthweight was inversely associated with cord IL-12p70 (-723 g; P = 0.001) and IFN-γ (-482 g, P = 0.007). Maternal cytokines during pregnancy did not correlate with umbilical cord cytokines at delivery.
  
  
  
  Systemic inflammation identified in maternal plasma or umbilical cord blood was associated with poorer birth anthropometrics in HIV-exposed and HIV-unexposed infants. Controlling maternal and/or foetal systemic inflammation may improve birth anthropometry.
authors.affiliation: Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA.
authors.forename: A L
authors.initials: AL
authors.lastname: Wilkinson
authors.affiliation: Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA.
authors.forename: S H
authors.initials: SH
authors.lastname: Pedersen
authors.affiliation: National Institute for Medical Research, Mwanza Research Centre, Mwanza, Tanzania.
authors.forename: M
authors.initials: M
authors.lastname: Urassa
authors.affiliation: National Institute for Medical Research, Mwanza Research Centre, Mwanza, Tanzania.
authors.forename: D
authors.initials: D
authors.lastname: Michael
authors.affiliation: Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: A
authors.initials: A
authors.lastname: Andreasen
authors.affiliation: Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: J
authors.initials: J
authors.lastname: Todd
authors.affiliation: National Institute for Medical Research, Mwanza Research Centre, Mwanza, Tanzania.
authors.forename: S M
authors.initials: SM
authors.lastname: Kinung'hi
authors.affiliation: National Institute for Medical Research, Mwanza Research Centre, Mwanza, Tanzania.
authors.forename: J
authors.initials: J
authors.lastname: Changalucha
authors.affiliation: Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA.|Division of Infectious Diseases & International Health, University of Virginia, Charlottesville, VA, USA.
authors.forename: J M
authors.initials: JM
authors.lastname: McDermid
mesh_terms: D000328:Adult; D001724:Birth Weight; D015992:Body Mass Index; D001837:Body Weights and Measures; D016207:Cytokines / Q000097:blood / Q000276:immunology*; D005260:Female; D005312:Fetal Blood / Q000276:immunology*; D015658:HIV Infections / Q000097:blood / Q000276:immunology*; D006454:Hemoglobins; D006801:Humans; D007231:Infant, Newborn; D007249:Inflammation / Q000097:blood / Q000276:immunology*; D018836:Inflammation Mediators / Q000097:blood / Q000276:immunology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000097:blood / Q000276:immunology*; D011446:Prospective Studies; D013636:Tanzania / Q000453:epidemiology
chemical_list: D016207:Cytokines; D006454:Hemoglobins; D018836:Inflammation Mediators
keywords: Africa; Afrique; Factor de Necrosis Tumoral alfa; Fetal; birthweight; embarazo; facteur de nécrose tumorale alpha; foetal; fœtal; grossesse; peso al nacer; poids à la naissance; pregnancy; rural health; salud rural; santé rurale; tumour necrosis factor-alpha; África