Document Detail


Influence of placental malaria infection on foetal outcome in the Gambia: twenty years after Ian Mcgregor.
MedLine Citation:
PMID:  12022158     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Malaria infection in pregnancy has serious health consequences among mothers and offspring. The influence of placental malaria infection on foetal outcome was studied in a Gambian rural setting where few pregnant women take antimalarial chemoprophylaxis. During July-December 1997, three hundred thirteen mother-newborn pairs (singletons only) were consecutively recruited into a study of the effects of placental malaria infection on the outcome of pregnancy. Placental blood and tissue were collected at delivery. Babies were clinically assessed until discharge. The overall prevalence of placental malaria infection was 51.1% by placental histology and 37.1% by blood smear. The primigravid women were more susceptible to placental malaria than the multigravidae (65.3% vs 44.7%, p=0.01). Placental malaria was significantly associated with pre-term deliveryand intrauterine growth retardation (p<0.01), and there was a four-fold risk of delivering low-birth-weight babies if mothers had parasitized placentae [OR=4.42, 95% confidence interval (CI) 2.10-9.27]. A reduction of mean birth-weight of babies by 320 g was associated with placental malaria infection (p<0.001). Similarly, a two-fold risk of stillbirth delivery (OR=2.22, 95% CI 1.04-4.72) was observed among the infected mothers. The findings showed that there was still an overall poor foetal outcome associated with placental malaria infection. The findings of this study confirm the findings of an earlier study by McGregor in the Gambia that the low birth-weight rate is significantly higher if the placenta is parasitized. In addition, this study observed that the high stillbirth and prematurity rates were associated with placental malaria infection. The findings of the present study suggest undertaking of effective malaria-control strategies during pregnancy, such as use of insecticide-impregnated bednets, intermittent and early treatment for malaria, and antimalarial chemoprophylaxis, in the Gambia.
Authors:
Brown J Okoko; Martin O Ota; Lawrence K Yamuah; David Idiong; Stella N Mkpanam; Akum Avieka; Winston A S Banya; Kike Osinusi
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of health, population, and nutrition     Volume:  20     ISSN:  1606-0997     ISO Abbreviation:  J Health Popul Nutr     Publication Date:  2002 Mar 
Date Detail:
Created Date:  2002-05-22     Completed Date:  2002-08-21     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  100959228     Medline TA:  J Health Popul Nutr     Country:  Bangladesh    
Other Details:
Languages:  eng     Pagination:  4-11     Citation Subset:  IM    
Affiliation:
Medical Research Council Laboratories, Fajara, West Africa. okokobrown@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Analysis of Variance
Biopsy
Embryonic and Fetal Development / physiology*
Female
Fetal Death / parasitology
Gambia
Humans
Infant, Low Birth Weight / physiology
Infant, Newborn
Malaria / blood*,  epidemiology*
Male
Middle Aged
Obstetric Labor, Premature / parasitology
Placenta / parasitology*,  pathology*
Pregnancy
Pregnancy Complications, Parasitic / blood*,  epidemiology*
Rural Population
Time Factors
Comments/Corrections
Comment In:
J Health Popul Nutr. 2002 Mar;20(1):1-3   [PMID:  12022152 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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