Document Detail


Epidemiology and burden of malaria in pregnancy.
MedLine Citation:
PMID:  17251080     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We reviewed evidence of the clinical implications and burden of malaria in pregnancy. Most studies come from sub-Saharan Africa, where approximately 25 million pregnant women are at risk of Plasmodium falciparum infection every year, and one in four women have evidence of placental infection at the time of delivery. P falciparum infections during pregnancy in Africa rarely result in fever and therefore remain undetected and untreated. Meta-analyses of intervention trials suggest that successful prevention of these infections reduces the risk of severe maternal anaemia by 38%, low birthweight by 43%, and perinatal mortality by 27% among paucigravidae. Low birthweight associated with malaria in pregnancy is estimated to result in 100,000 infant deaths in Africa each year. Although paucigravidae are most affected by malaria, the consequences for infants born to multigravid women in Africa may be greater than previously appreciated. This is because HIV increases the risk of malaria and its adverse effects, particularly in multigravidae, and recent observational studies show that placental infection almost doubles the risk of malaria infection and morbidity in infants born to multigravidae. Outside Africa, malaria infection rates in pregnant women are much lower but are more likely to cause severe disease, preterm births, and fetal loss. Plasmodium vivax is common in Asia and the Americas and, unlike P falciparum, does not cytoadhere in the placenta, yet, is associated with maternal anaemia and low birthweight. The effect of infection in the first trimester, and the longer term effects of malaria beyond infancy, are largely unknown and may be substantial. Better estimates are also needed of the effects of malaria in pregnancy outside Africa, and on maternal morbidity and mortality in Africa. Global risk maps will allow better estimation of potential impact of successful control of malaria in pregnancy.
Authors:
Meghna Desai; Feiko O ter Kuile; François Nosten; Rose McGready; Kwame Asamoa; Bernard Brabin; Robert D Newman
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  The Lancet infectious diseases     Volume:  7     ISSN:  1473-3099     ISO Abbreviation:  Lancet Infect Dis     Publication Date:  2007 Feb 
Date Detail:
Created Date:  2007-01-25     Completed Date:  2007-03-02     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  101130150     Medline TA:  Lancet Infect Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  93-104     Citation Subset:  IM    
Affiliation:
Malaria Branch, Division of Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA. mdesai@cdc.gov
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MeSH Terms
Descriptor/Qualifier:
Adult
Africa / epidemiology
Americas / epidemiology
Animals
Asia / epidemiology
Female
Humans
Infant Mortality
Infant, Newborn
Infectious Disease Transmission, Vertical*
Malaria, Falciparum / complications*,  epidemiology*,  parasitology,  transmission
Malaria, Vivax / epidemiology*
Maternal Welfare
Parasitemia / epidemiology,  parasitology
Pregnancy
Pregnancy Complications, Parasitic / epidemiology*,  parasitology
Pregnancy Outcome
Grant Support
ID/Acronym/Agency:
//Wellcome Trust
Comments/Corrections
Comment In:
Lancet Infect Dis. 2007 Dec;7(12):763-4   [PMID:  18045558 ]

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