Intrauterine Growth Restriction in Babies Born to Cameroonian HIV-Positive Women: Identification of Possible Mechanisms Responsible for Low Birth Weight
HIV increases the risk of intrauterine growth restriction (IUGR), which results in the delivery of low birth weight (LBW) babies, who are 40 times more likely to die during their first year of life. However, the mechanism(s) for IUGR among HIV-exposed newborns remain unknown. In addition to socioeconomic and cultural factors, several hypotheses have been proposed to explain the biological component of IUGR. These include reduced 1) placental angiogenesis and vasculogenesis, 2) production of fetal growth hormones, and 3) transportation of nutrients. The first two hypotheses were examined in this investigation. To evaluate altered vessel formation, placental plasma levels of angiopoietins, ANG-1 and ANG-2, and galectin-13 were measured. Levels of insulin-like growth factor-1 (IGF-1) and one of its binding proteins, IGFBP-1, were measured to evaluate growth hormone dysregulation. In this case-control study, 21 HIV-positive and 30 HIV-negative pregnant mothers were recruited at delivery in the Central Hospital of Yaoundé, Cameroon, Africa. Results showed that biomarker levels in HIV-negative women were similar to literature values for healthy adults; but no significant differences were observed among the different groups. However a statistically significant (p=0.028) declining pattern of galectin-13 levels was noted as the severity of HIV infection increased. Overall, our results suggest that decreased angiogenesis and reduced production of growth factors may not cause LBW, but the dysregulation of maternal vascular development may play a role. Further studies using additional biomarkers are needed to identify the combination of social, economic and biological risk factors that increase the risk of HIV-associated LBW babies.Microbiolog
