Abstract
BackgroundThe pathogenesis of malaria during pregnancy is not completely understood. There are few published data on complement activation and malaria during pregnancy. This study aimed to investigate complement activation and malaria during pregnancy, and their association with hemoglobin and birth weight.MethodsA cross-sectional study was conducted at Medani, Sudan. Soluble terminal complement complex (TCC) levels were measured using ELISA in maternal and cord blood samples from 126 parturient women.ResultsThere were no Plasmodium falciparum-positive blood films from maternal peripheral blood, the placenta, or cord blood samples. Three (2.4%) and 22 (17.5%) of the placentas showed chronic and previous infection with histopathological examination, respectively, while 101 (80.2%) of them had no malaria infection. The mean [SD] of the maternal (22.4 [6.1] vs. 26.5 [3.5] ng/ml, P < 0.001) and cord blood (24.5 [4.5] vs. 26.8 [4.4] ng/ml, P = 0.024) TCC levels were significantly lower in cases of placental malaria infection (n = 25) than in those without placental malaria infection (n = 101). Linear regression showed that placental malaria infection was significantly associated with birth weight (−0.353 g, P = 0.013), but there were no associations between maternal and cord TCC levels and maternal hemoglobin, or between TCC levels and birth weight.ConclusionMaternal and cord blood TCC levels are lower in women with placental malaria infection than in those without placental malaria infection.Virtual SlideThe virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/9600054761463915
Highlights
The pathogenesis of malaria during pregnancy is not completely understood
Pregnant Sudanese women are susceptible to malaria, regardless of their age and parity, and malaria is associated with anemia and low birth weight (LBW) in these women [6,7,8]
Maternal and cord blood terminal complement complex (TCC) levels were significantly lower in women with placental malaria infection than in those without placental malaria infection, and they had no effect on maternal hemoglobin levels and birth weight
Summary
There are few published data on complement activation and malaria during pregnancy. This study aimed to investigate complement activation and malaria during pregnancy, and their association with hemoglobin and birth weight. Malaria during pregnancy can lead to adverse maternal and perinatal effects, mainly anemia and low birth weight (LBW) [3,4,5]. Pregnant Sudanese women are susceptible to malaria (even the severe form), regardless of their age and parity, and malaria is associated with anemia and LBW in these women [6,7,8]. The exact mechanism by which malaria infection and placental inflammation result in fetal growth restriction and LBW is poorly understood. Many chemokines and inflammatory cytokines are associated with malaria infection and malaria-related LBW [9].
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