Document Detail

Malaria in pregnancy and its consequences for the infant in rural Malawi.
MedLine Citation:
PMID:  10715686     Owner:  NLM     Status:  MEDLINE    
Maternal malaria and anaemia, pregnancy and infant outcomes are reviewed among a cohort of mothers and their babies living in Chikwawa district, southern Malawi. Overall, 4104 women were screened at first antenatal visit and 1523 at delivery. Factors independently associated with moderately severe anaemia (MSA; < 8 g haemoglobin/dl) in primigravidae were malaria (relative risk = 1.9; 95% confidence interval = 1.6-2.3) and iron deficiency (relative risk = 4.2; 95% confidence interval = 3.5-5.0). Only iron deficiency was associated with MSA in multigravidae. After controlling for antimalarial use, parasitaemia was observed in 56.3% of the HIV-infected primigravidae and 36.5% of the non-infected (P = 0.04). The corresponding figures for multigravidae were 23.8% and 11.0%, respectively (P = 0.002). Over 33% of the infants born alive to primigravidae were of low birthweight (LBW; < 2500 g), and 23.3% of all newborns had foetal anaemia (< 12.5 g haemoglobin/dl cord blood). LBW was significantly associated in primigravidae with pre-term delivery, placental malaria and frequency of treatment with sulfadoxine-pyrimethamine (SP), and in multigravidae with pre-term delivery, adolescence, short stature and MSA. LBW was significantly reduced with a second SP treatment in primigravidae, and with iron-folate supplementation in multigravidae. Mean haemoglobin concentrations were significantly lower in the infant who had been LBW babies than in the others, and significantly associated with parity, peripheral parasitaemia at delivery and placental malaria. At 1 year post-delivery, life status was known for 364 (80.7%) of the 451 infants enrolled in the follow-up study. Independent risk factors for post-neonatal mortality were maternal HIV infection, LBW, and iron deficiency at delivery. This study identifies priorities for improving the health of pregnant women and their babies in this rural area of Malawi.
F H Verhoeff; B J Brabin; L Chimsuku; P Kazembe; R L Broadhead
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Annals of tropical medicine and parasitology     Volume:  93 Suppl 1     ISSN:  0003-4983     ISO Abbreviation:  Ann Trop Med Parasitol     Publication Date:  1999 Dec 
Date Detail:
Created Date:  2000-04-13     Completed Date:  2000-04-13     Revised Date:  2009-05-18    
Medline Journal Info:
Nlm Unique ID:  2985178R     Medline TA:  Ann Trop Med Parasitol     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  S25-33     Citation Subset:  IM; X    
Liverpool School of Tropical Medicine, U.K.
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MeSH Terms
Anemia / blood,  epidemiology*,  etiology
Birth Weight
Cohort Studies
Gestational Age
HIV Infections / blood,  complications,  epidemiology
Infant, Newborn
Malaria / blood,  complications,  epidemiology*
Malawi / epidemiology
Pregnancy Complications, Parasitic / blood,  epidemiology*

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