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Title: The effects of Plasmodium falciparum and P. vivax infections on placental histopathology in an area of low malaria transmission
Authors: Rose McGready
Billie B. Davison
Kasia Stepniewska
Thein Cho
Htee Shee
Alan Brockman
Rachanee Udomsangpetch
Sornchai Looareesuwan
Nicholas J. White
Steve R. Meshnick
François Nosten
Shoklo Malaria Research Unit
Tulane National Primate Research Center
Mahidol University
The University of North Carolina at Chapel Hill
Keywords: Immunology and Microbiology;Medicine
Issue Date: 1-Apr-2004
Citation: American Journal of Tropical Medicine and Hygiene. Vol.70, No.4 (2004), 398-407
Abstract: Placental histopathology was studied in a cohort of 204 women living in an area of low Plasmodium falciparum and P. vivax malaria transmission. Detection of malaria antenatally was active, by weekly peripheral blood smears, and all infections were treated. Significant histopathologic placental malaria changes (increased malaria pigment, cytotrophoblastic prominence, and presence of parasites) were found only in a minority of women who had P. falciparum infections in pregnancy. These changes were significantly more frequent in women with evidence of peripheral blood infection close to delivery and only in these cases were placental inflammatory cells increased. Antenatal P. vivax infection was associated only with the presence of malaria pigment in the placenta. All placental infections diagnosed by blood smear and 32.4% (12 of 37) diagnosed by histopathology were associated with patent peripheral parasitemia. This study indicates that prompt treatment of peripheral parasitemias during pregnancy limits placental pathology. The effect on birth weight reduction may not result from irreversible placental changes but from the acute insult of infection. These findings emphasize the importance of treating malaria in pregnancy promptly with effective antimalarial drugs.
ISSN: 00029637
Appears in Collections:Scopus 2001-2005

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