Malaria Infections and Placental Blood Flow: A Doppler Ultrasound Study from a Preconception Cohort in Benin
Issued Date
2023-08-01
Resource Type
eISSN
23288957
Scopus ID
2-s2.0-85168778598
Journal Title
Open Forum Infectious Diseases
Volume
10
Issue
8
Rights Holder(s)
SCOPUS
Bibliographic Citation
Open Forum Infectious Diseases Vol.10 No.8 (2023)
Suggested Citation
Mondeilh A., Yovo E., Accrombessi M., Hounkonnou C., Agbota G., Atade W., Ladikpo O.T., Mehoba M., Degbe A., Vianou B., Sossou D., Ndam N.T., Massougbodji A., McGready R., Fievet N., Rijken M.J., Cottrell G., Briand V. Malaria Infections and Placental Blood Flow: A Doppler Ultrasound Study from a Preconception Cohort in Benin. Open Forum Infectious Diseases Vol.10 No.8 (2023). doi:10.1093/ofid/ofad376 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/89162
Title
Malaria Infections and Placental Blood Flow: A Doppler Ultrasound Study from a Preconception Cohort in Benin
Author's Affiliation
Mère et Enfant en Milieu Tropical : Pathogènes, Système de Santé et Transition Epidémiologique
Mahidol Oxford Tropical Medicine Research Unit
Bordeaux Population Health Research Center (BPH)
Université de Montpellier
University Medical Center Utrecht
London School of Hygiene & Tropical Medicine
Hôpital Bichat-Claude-Bernard AP-HP
University Sorbonne Paris Nord
Nuffield Department of Medicine
Institut de Recherche Clinique du Bénin
Mahidol Oxford Tropical Medicine Research Unit
Bordeaux Population Health Research Center (BPH)
Université de Montpellier
University Medical Center Utrecht
London School of Hygiene & Tropical Medicine
Hôpital Bichat-Claude-Bernard AP-HP
University Sorbonne Paris Nord
Nuffield Department of Medicine
Institut de Recherche Clinique du Bénin
Other Contributor(s)
Abstract
Background: Malaria in pregnancy (MiP) has been associated with fetal growth restriction, the underlying pathogenic mechanisms of which remain poorly understood. Malaria in pregnancy is suspected to induce abnormalities in placental vascularization, leading to impaired placental development. Our study evaluated MIP's effect on uterine artery (UtA) and umbilical artery (UA) blood flow. Methods: The analysis included 253 Beninese women followed throughout pregnancy and screened monthly for submicroscopic and microscopic malaria. Uterine artery Doppler measurement was performed once between 21 and 25 weeks' gestation (wg), and UA Doppler measurement was performed 1-3 times from 28 wg. Linear and logistic regression models were used to assess the effect of malaria infections on UtA Doppler indicators (pulsatility index and presence of a notch), whereas a logistic mixed model was used to assess the association between malaria infections and abnormal UA Doppler (defined as Z-score ≥2 standard deviation or absent/reversed UA end-diastolic flow). Results: Primigravidae represented 7.5% of the study population; 42.3% of women had at least 1 microscopic infection during pregnancy, and 29.6% had at least 1 submicroscopic infection (and no microscopic infection). Both microscopic and submicroscopic infections before Doppler measurement were associated with the presence of a notch (adjusted odds ratio [aOR] 4.5, 95% confidence interval [CI] = 1.2-16.3 and aOR 3.3, 95% CI =. 9-11.9, respectively). No associations were found between malaria before the Doppler measurement and abnormal UA Doppler. Conclusions: Malaria infections in the first half of pregnancy impair placental blood flow. This highlights the need to prevent malaria from the very beginning of pregnancy.