Abstract
BackgroundUnderstanding the pathogenesis of malaria in pregnancy and its consequences for both the mother and the baby is fundamental for improving malaria control in pregnant women.AimThe study aimed to investigate the role of ABO blood groups on pregnancy outcomes in an area of unstable malaria transmission in eastern Sudan.MethodsA total of 293 women delivering in New Half teaching hospital, eastern Sudan during the period October 2006–March 2007 have been analyzed. ABO blood groups were determined and placental histopathology examinations for malaria were performed. Birth and placental weight were recorded and maternal haemoglobin was measured.Results114 (39.7%), 61 (22.1%) and 118 (38.2%) women were primiparae, secundiparae and multiparae, respectively. The ABO blood group distribution was 82(A), 59 (B), 24 (AB) and 128 (O). Placental histopathology showed acute placental malaria infections in 6 (2%), chronic infections in 6 (2%), 82 (28.0%) of the placentae showed past infection and 199 (68.0%) showed no infection. There was no association between the age (OR = 1.02, 95% CI = 0.45–2.2; P = 0.9), parity (OR = 0.6, 95% CI = 0.3–1.2; P = 0.1) and placental malaria infections. In all parity blood group O was associated with a higher risk of past (OR = 1.9, 95% CI = 1.1–3.2; P = 0.01) placental malaria infection. This was also true when primiparae were considered separately (OR = 2.6, 95% CI = 1.05–6.5, P = 0.03).Among women with all placental infections/past placental infection, the mean haemoglobin was higher in women with the blood group O, but the mean birth weight, foeto-placental weight ratio was not different between these groups and the non-O group.ConclusionThese results indicate that women of eastern Sudan are at risk for placental malaria infection irrespective to their age or parity. Those women with blood group O were at higher risk of past placental malaria infection.
Highlights
Understanding the pathogenesis of malaria in pregnancy and its consequences for both the mother and the baby is fundamental for improving malaria control in pregnant women
These results indicate that women of eastern Sudan are at risk for placental malaria infection irrespective to their age or parity
Malaria during pregnancy poses a substantial risk to the mother, her foetus and the neonate [2]: it is a major health problem in Sudan, where it has been reported to be associated with maternal anaemia, low birth weight infants and a major cause of maternal mortality [3,4,5,6]
Summary
Understanding the pathogenesis of malaria in pregnancy and its consequences for both the mother and the baby is fundamental for improving malaria control in pregnant women. It has been estimated that 90% of the global malaria burden occurs in sub-Saharan Africa, where 40% women are exposed to malaria infections during pregnancy [1]. Cell adhesion plays a fundamental role in placental malaria pathophysiology [7]. Cell surface glycans, such as the ABO and related antigens could modulate some of those specific cell interactions [8]. Some strains of Plasmodium falciparum preferentially trigger rosette formation depending on the red blood cell blood group [9]. The rosette formation is not a feature of P. falciparum infections during pregnancy [10]
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