Document Detail


Malaria in pregnancy: adverse effects on haemoglobin levels and birthweight in primigravidae and multigravidae.
MedLine Citation:
PMID:  11679125     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: In areas of endemic transmission, malaria in pregnancy is associated with severe maternal anaemia and low birthweight babies. The prevalence of infection is highest in primigravidae (PG), and hence control efforts are usually geared towards this high risk group. Using a sensitive measure of placental infection, we investigated the relationship between active-acute, active-chronic and past placental infection with maternal anaemia and low birthweight in women of all gravidities. METHODS: Between January 1996 and July 1997, 912 women delivering in Kilifi District Hospital, Kenya, were recruited. Haemoglobin and peripheral malaria slides were taken prior to delivery, placental biopsies and smears were taken at the time of delivery and birthweight and maternal height and weight were measured soon after birth. Information was obtained on socio-economic and educational status. The association between placental malaria, severe anaemia and low birthweight was investigated for women of different gravidities. FINDINGS: By placental histology, the prevalence of active or past malaria in all gravidities was high, ranging from 64% in PG to 30% in gravidities 5 and above. In gravidities 1-4, active malaria infection was associated with severe maternal anaemia, adjusted OR 2.21 (95% CI 1.36, 3.61). There was a significant interaction between chronic or past malaria and severe anaemia in their effects on birthweight, whereby the risk of low birthweight was very high in women with both chronic or past placental malaria and severe anaemia: OR 4.53 (1.19, 17.2) in PG; 13.5 (4.57, 40) in gravidities 2-4. INTERPRETATION: In this area of moderate malaria transmission, women of all parities have substantially increased risk of low birthweight and severe anaemia as a result of malaria infection in pregnancy. The risk of low birthweight is likely to be particularly high in areas with a high prevalence of severe anaemia.
Authors:
C E Shulman; T Marshall; E K Dorman; J N Bulmer; F Cutts; N Peshu; K Marsh
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Tropical medicine & international health : TM & IH     Volume:  6     ISSN:  1360-2276     ISO Abbreviation:  Trop. Med. Int. Health     Publication Date:  2001 Oct 
Date Detail:
Created Date:  2001-10-26     Completed Date:  2001-12-04     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9610576     Medline TA:  Trop Med Int Health     Country:  England    
Other Details:
Languages:  eng     Pagination:  770-8     Citation Subset:  IM    
Affiliation:
London School of Hygiene and Tropical Medicine, London, UK. caroline.shulman@lshtm.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Anemia, Hemolytic / blood,  epidemiology*,  etiology
Birth Weight*
Female
Hemoglobins / metabolism*
Humans
Infant, Newborn
Kenya / epidemiology
Malaria, Falciparum / blood,  complications,  epidemiology*
Parity
Pregnancy
Pregnancy Complications, Hematologic / blood,  epidemiology*
Pregnancy Complications, Parasitic / blood,  epidemiology*
Prevalence
Questionnaires
Chemical
Reg. No./Substance:
0/Hemoglobins

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