Association of Maternal Inflammation During Pregnancy With Birth Outcomes and Infant Growth Among Women With or Without HIV in India

Abstract

Key Points Question Is elevated inflammation in pregnant women with or without HIV associated with adverse birth outcomes and infant growth deficits? Findings In this cohort study of pregnant women in Pune, India, higher levels during pregnancy of interleukin 17A were associated with increased odds of both preterm birth and low birth weight. Higher levels of interleukin 1β were associated with increased preterm birth and infant growth deficits. Meaning This study suggests that elevated inflammation during pregnancy is associated with adverse birth outcomes and infant growth deficits, and future studies should test whether modulating specific inflammatory pathways could reduce adverse birth outcomes and growth deficits.

Biomarkers of environmental enteric dysfunction and adverse birth outcomes: An observational study among pregnant women living with HIV in Tanzania

“… 43 In contrast, a recent study in India among 218 women, 32% of whom were PWLHIV, found no associations between AGP or CRP and low birthweight or preterm birth, either overall or by maternal HIV status. 18 However, the same study found associations between increased interleukin-1β, another marker of systemic inflammation, and increased odds of preterm birth, both overall and among PWLHIV. 18 Other studies have also found high levels of CRP early in pregnancy to be associated with increased risk of preterm birth, as well as the risk of preeclampsia and growth restriction.…”

“… 18 However, the same study found associations between increased interleukin-1β, another marker of systemic inflammation, and increased odds of preterm birth, both overall and among PWLHIV. 18 Other studies have also found high levels of CRP early in pregnancy to be associated with increased risk of preterm birth, as well as the risk of preeclampsia and growth restriction. 21 One reason for inconsistent findings on CRP between studies may be the timing of CRP measurement as well as the role of HIV which is known to contribute to heightened immune activation and inflammatory response even with ART.…”

“…Inflammation during pregnancy has been previously linked to adverse pregnancy outcomes. 18 , 21 Maternal inflammation can lead to placental and foetal inflammation impairing vascular development and gestational growth, and infections in pregnancy leading to a heightened immune state can further contribute to adverse birth outcomes. 20 , 41 Our finding is similar to a study in Nepal that found that higher levels of maternal serum AGP, but not CRP, were associated with smaller birth size, including weight, length, head circumference, and chest circumference, suggesting chronic low-grade inflammation may inhibit foetal growth.…”

“…One of the features of EED is systemic inflammation, 10 , 19 which is associated with adverse birth outcomes, 20 , 21 including among PWLHIV. 18 Systemic inflammation also alters the growth hormone axis which affects growth promotion and regulation. 22 Studies have shown that the growth hormone axis is involved with placental function and prenatal growth.…”

Maternal Dietary Inflammatory Index during Pregnancy Is Associated with Perinatal Outcomes: Results from the IMPACT BCN Trial

“…Diet significantly contributes to increasing the pregnancy risk from early gestation [ 8 ], playing a key role in the regulation of chronic inflammation in pregnant and non-pregnant adults [ 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 ]. In fact, several high-quality studies, reviews, and meta-analyses have demonstrated that the Mediterranean diet (MD) is a healthy dietary pattern and that higher adherence to MD is associated with the prevention of several diseases and lower inflammatory levels [ 18 , 19 , 20 , 21 ].…”