Publication: Impact of malaria during pregnancy on pregnancy outcomes in a Ugandan prospective cohort with intensive malaria screening and prompt treatment
Accepted Date
2013-04-07
Issued Date
2013-04-24
Copyright Date
2013
Resource Type
Language
eng
ISSN
1475-2875 (electronic)
Rights
Mahidol University
Rights Holder(s)
BioMed Central
Bibliographic Citation
De Beaudrap P, Turyakira E, White LJ, Nabasumba C, Tumwebaze B, Muehlenbachs A, et al. Impact of malaria during pregnancy on pregnancy outcomes in a Ugandan prospective cohort with intensive malaria screening and prompt treatment. Malar J. 2013 Apr 24;12:139.
Suggested Citation
Beaudrap, Pierre De, Turyakira, Eleanor, White, Lisa J., Nabasumba, Carolyn, Tumwebaze, Benon, Muehlenbachs, Atis, Guérin, Philippe J., II, Yap Boum, McGready, Rose, Piola, Patrice Impact of malaria during pregnancy on pregnancy outcomes in a Ugandan prospective cohort with intensive malaria screening and prompt treatment. De Beaudrap P, Turyakira E, White LJ, Nabasumba C, Tumwebaze B, Muehlenbachs A, et al. Impact of malaria during pregnancy on pregnancy outcomes in a Ugandan prospective cohort with intensive malaria screening and prompt treatment. Malar J. 2013 Apr 24;12:139.. doi:10.1186/1475-2875-12-139 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/742
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Title
Impact of malaria during pregnancy on pregnancy outcomes in a Ugandan prospective cohort with intensive malaria screening and prompt treatment
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Abstract
BACKGROUND: Malaria in pregnancy (MiP) is a major public health problem in
endemic areas of sub-Saharan Africa and has important consequences on birth
outcome. Because MiP is a complex phenomenon and malaria epidemiology is rapidly
changing, additional evidence is still required to understand how best to control
malaria. This study followed a prospective cohort of pregnant women who had
access to intensive malaria screening and prompt treatment to identify factors
associated with increased risk of MiP and to analyse how various characteristics
of MiP affect delivery outcomes.
METHODS: Between October 2006 and May 2009, 1,218 pregnant women were enrolled in
a prospective cohort. After an initial assessment, they were screened weekly for
malaria. At delivery, blood smears were obtained from the mother, placenta, cord
and newborn. Multivariate analyses were performed to analyse the association
between mothers' characteristics and malaria risk, as well as between MiP and
birth outcome, length and weight at birth. This study is a secondary analysis of
a trial registered with ClinicalTrials.gov, number NCT00495508.
RESULTS: Overall, 288/1,069 (27%) mothers had 345 peripheral malaria infections.
The risk of peripheral malaria was higher in mothers who were younger, infected
with HIV, had less education, lived in rural areas or reported no bed net use,
whereas the risk of placental infection was associated with more frequent malaria
infections and with infection during late pregnancy. The risk of pre-term
delivery and of miscarriage was increased in mothers infected with HIV, living in
rural areas and with MiP occurring within two weeks of delivery.In adjusted
analysis, birth weight but not length was reduced in babies of mothers exposed to
MiP (-60 g, 95%CI: -120 to 0 for at least one infection and -150 g, 95%CI: -280
to -20 for >1 infections).
CONCLUSIONS: In this study, the timing, parasitaemia level and number of
peripherally-detected malaria infections, but not the presence of fever, were
associated with adverse birth outcomes. Hence, prompt malaria detection and
treatment should be offered to pregnant women regardless of symptoms or other
preventive measures used during pregnancy, and with increased focus on mothers
living in remote areas.