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The effects of malaria and intermittent preventive treatment during pregnancy on fetal anemia in Malawi.
MedLine Citation:
PMID:  22767651     Owner:  NLM     Status:  Publisher    
Background. Fetal anemia is common in malarious areas and is a risk factor for infant morbidity and mortality. Malaria during pregnancy may cause decreased cord hemoglobin (Hb) and fetal anemia among newborns. Intermittent preventive treatment in pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP) is protective against malaria, but may also affect hematopoiesis and contribute to fetal anemia.Methods. Peripheral, placental, and cord blood were examined for malaria parasitemia and hemoglobin concentration in a cross-section of 3,848 mothers and infants delivered at Queen Elizabeth Central Hospital in Blantyre, Malawi between 1997 and 2006. Unconditional linear and logistic regressions were performed with multiple imputation for missing covariates to assess the associations between malaria, IPTp with SP, and fetal anemia.Results. The overall prevalence of fetal anemia was 7.9% (n=304). Malaria parasitemia at delivery was associated with an adjusted decrease in cord Hb of -0.24 g/dL (95% confidence interval (CI): -0.42, -0.05). The adjusted prevalence odds ratio for the effect of malaria on fetal anemia was 1.41 (95% CI: 1.05, 1.90). Primigravidae who did not take IPTp had infants at highest risk for fetal anemia, and density of parasitemia was correlated with the decrease in cord Hb. There was no significant association between SP use and cord Hb or fetal anemia.Conclusion.  Malaria during pregnancy, but not IPTp, decreases cord Hb and is a risk factor for fetal anemia in Malawi. IPTp with SP may continue to be safe and effective in preventing malaria during pregnancy and fetal anemia despite development of SP resistance.
Elizabeth T Rogawski; Ebbie Chaluluka; Malcolm E Molyneux; Gaoqian Feng; Stephen J Rogerson; Steven R Meshnick
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-7-5
Journal Detail:
Title:  Clinical infectious diseases : an official publication of the Infectious Diseases Society of America     Volume:  -     ISSN:  1537-6591     ISO Abbreviation:  -     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-7-6     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9203213     Medline TA:  Clin Infect Dis     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina, USA.
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