Publication:
Pregnancy outcomes and risk of placental malaria after artemisinin-based and quinine-based treatment for uncomplicated falciparum malaria in pregnancy: A WorldWide Antimalarial Resistance Network systematic review and individual patient data meta-analysis

Issued Date

2020-06-02

Resource Type

Review

ISSN

17417015

DOI

10.1186/s12916-020-01592-z

Other identifier(s)

2-s2.0-85085676994

Rights

Mahidol University

Rights Holder(s)

SCOPUS

Bibliographic Citation

BMC Medicine. Vol.18, No.1 (2020)

Suggested Citation

Makoto Saito, Makoto Saito, Makoto Saito, Rashid Mansoor, Kalynn Kennon, Anupkumar R. Anvikar, Elizabeth A. Ashley, Daniel Chandramohan, Lauren M. Cohee, Umberto D'Alessandro, Blaise Genton, Mary Ellen Gilder, Elizabeth Juma, Linda Kalilani-Phiri, Irene Kuepfer, Miriam K. Laufer, Khin Maung Lwin, Steven R. Meshnick, Dominic Mosha, Atis Muehlenbachs, Victor Mwapasa, Norah Mwebaza, Michael Nambozi, Jean Louis A. Ndiaye, François Nosten, François Nosten, Myaing Nyunt, Bernhards Ogutu, Sunil Parikh, Moo Kho Paw, Aung Pyae Phyo, Mupawjay Pimanpanarak, Patrice Piola, Marcus J. Rijken, Kanlaya Sriprawat, Harry K. Tagbor, Joel Tarning, Halidou Tinto, Innocent Valéa, Neena Valecha, Nicholas J. White, Nicholas J. White, Jacher Wiladphaingern, Kasia Stepniewska, Kasia Stepniewska, Rose McGready, Rose McGready, Philippe J. Guérin Pregnancy outcomes and risk of placental malaria after artemisinin-based and quinine-based treatment for uncomplicated falciparum malaria in pregnancy: A WorldWide Antimalarial Resistance Network systematic review and individual patient data meta-analysis. BMC Medicine. Vol.18, No.1 (2020). doi:10.1186/s12916-020-01592-z Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/58135

Research Projects

Organizational Units

Authors

Journal Issue

Thesis

Title

Pregnancy outcomes and risk of placental malaria after artemisinin-based and quinine-based treatment for uncomplicated falciparum malaria in pregnancy: A WorldWide Antimalarial Resistance Network systematic review and individual patient data meta-analysis

Author(s)

Makoto Saito
 Makoto Saito
 Makoto Saito
 Rashid Mansoor
 Kalynn Kennon
 Anupkumar R. Anvikar
 Elizabeth A. Ashley
 Daniel Chandramohan
 Lauren M. Cohee
 Umberto D'Alessandro
 Blaise Genton
 Mary Ellen Gilder
 Elizabeth Juma
 Linda Kalilani-Phiri
 Irene Kuepfer
 Miriam K. Laufer
 Khin Maung Lwin
 Steven R. Meshnick
 Dominic Mosha
 Atis Muehlenbachs
 Victor Mwapasa
 Norah Mwebaza
 Michael Nambozi
 Jean Louis A. Ndiaye
 François Nosten
 François Nosten
 Myaing Nyunt
 Bernhards Ogutu
 Sunil Parikh
 Moo Kho Paw
 Aung Pyae Phyo
 Mupawjay Pimanpanarak
 Patrice Piola
 Marcus J. Rijken
 Kanlaya Sriprawat
 Harry K. Tagbor
 Joel Tarning
 Halidou Tinto
 Innocent Valéa
 Neena Valecha
 Nicholas J. White
 Nicholas J. White
 Jacher Wiladphaingern
 Kasia Stepniewska
 Kasia Stepniewska
 Rose McGready
 Rose McGready
 Philippe J. Guérin

Other Contributor(s)

Centre Universitaire de Médecine Générale et Santé Publique
 University of Health and Allied Sciences, Ghana
 University of Malawi College of Medicine
 Medical Research Council Laboratories Gambia
 Institut Pasteur du Cambodge
 Makerere University
 Ifakara Health Institute
 Universite Cheikh Anta Diop
 Kenya Medical Research Institute
 Shoklo Malaria Research Unit
 University Medical Center Utrecht
 London School of Hygiene & Tropical Medicine
 The University of North Carolina at Chapel Hill
 National Institute of Malaria Research India
 Universitat Basel
 Swiss Tropical and Public Health Institute (Swiss TPH)
 University of Washington, Seattle
 Mahosot Hospital, Lao
 University of Maryland School of Medicine
 Mahidol University
 Nuffield Department of Medicine
 Duke University
 Yale University
 Myanmar Oxford Clinical Research Unit
 Infectious Diseases Data Observatory (IDDO)
 Institut de Recherche en Sciences de la Santé
 WorldWide Antimalarial Resistance Network (WWARN)
 Tropical Diseases Research Centre

Abstract

© 2020 The Author(s). Background: Malaria in pregnancy, including asymptomatic infection, has a detrimental impact on foetal development. Individual patient data (IPD) meta-analysis was conducted to compare the association between antimalarial treatments and adverse pregnancy outcomes, including placental malaria, accompanied with the gestational age at diagnosis of uncomplicated falciparum malaria infection. Methods: A systematic review and one-stage IPD meta-analysis of studies assessing the efficacy of artemisinin-based and quinine-based treatments for patent microscopic uncomplicated falciparum malaria infection (hereinafter uncomplicated falciparum malaria) in pregnancy was conducted. The risks of stillbirth (pregnancy loss at ≥ 28.0 weeks of gestation), moderate to late preterm birth (PTB, live birth between 32.0 and < 37.0 weeks), small for gestational age (SGA, birthweight of < 10th percentile), and placental malaria (defined as deposition of malaria pigment in the placenta with or without parasites) after different treatments of uncomplicated falciparum malaria were assessed by mixed-effects logistic regression, using artemether-lumefantrine, the most used antimalarial, as the reference standard. Registration PROSPERO: CRD42018104013. Results: Of the 22 eligible studies (n = 5015), IPD from16 studies were shared, representing 95.0% (n = 4765) of the women enrolled in literature. Malaria treatment in this pooled analysis mostly occurred in the second (68.4%, 3064/4501) or third trimester (31.6%, 1421/4501), with gestational age confirmed by ultrasound in 91.5% (4120/4503). Quinine (n = 184) and five commonly used artemisinin-based combination therapies (ACTs) were included: artemether-lumefantrine (n = 1087), artesunate-amodiaquine (n = 775), artesunate-mefloquine (n = 965), and dihydroartemisinin-piperaquine (n = 837). The overall pooled proportion of stillbirth was 1.1% (84/4361), PTB 10.0% (619/4131), SGA 32.3% (1007/3707), and placental malaria 80.1% (2543/3035), and there were no significant differences of considered outcomes by ACT. Higher parasitaemia before treatment was associated with a higher risk of SGA (adjusted odds ratio [aOR] 1.14 per 10-fold increase, 95% confidence interval [CI] 1.03 to 1.26, p = 0.009) and deposition of malaria pigment in the placenta (aOR 1.67 per 10-fold increase, 95% CI 1.42 to 1.96, p < 0.001). Conclusions: The risks of stillbirth, PTB, SGA, and placental malaria were not different between the commonly used ACTs. The risk of SGA was high among pregnant women infected with falciparum malaria despite treatment with highly effective drugs. Reduction of malaria-associated adverse birth outcomes requires effective prevention in pregnant women.

Keyword(s)

Medicine

Availability

URI

https://repository.li.mahidol.ac.th/handle/20.500.14594/58135

Collections

Scopus 2020