Abstract
BackgroundMalaria in pregnancy has a negative impact on foetal growth, but it is not known whether this also affects the foetal nervous system. The aim of this study was to examine the effects of malaria on foetal cortex development by three-dimensional ultrasound.MethodsBrain images were acquired using a portable ultrasound machine and a 3D ultrasound transducer. All recordings were analysed, blinded to clinical data, using the 4D view software package. The foetal supra-tentorial brain volume was determined and cortical development was qualitatively followed by scoring the appearance and development of six sulci. Multilevel analysis was used to study brain volume and cortical development in individual foetuses.ResultsCortical grading was possible in 161 out of 223 (72%) serial foetal brain images in pregnant women living in a malaria endemic area. There was no difference between foetal cortical development or brain volumes at any time in pregnancy between women with immediately treated malaria infections and non-infected pregnancies.ConclusionThe percentage of images that could be graded was similar to other neuro-sonographic studies. Maternal malaria does not have a gross effect on foetal brain development, at least in this population, which had access to early detection and effective treatment of malaria.
Highlights
Malaria in pregnancy has a negative impact on foetal growth, but it is not known whether this affects the foetal nervous system
Malaria in pregnancy causes a decrease in birth weight by intra-uterine growth restriction (IUGR), preterm delivery, or both [3]
Population The participants in this study were attending the antenatal clinic (ANC) at Shoklo Malaria Research Unit (SMRU), which is located on the Thai-Burmese border where malaria transmission is low and seasonal [10]
Summary
Malaria in pregnancy has a negative impact on foetal growth, but it is not known whether this affects the foetal nervous system. The aim of this study was to examine the effects of malaria on foetal cortex development by three-dimensional ultrasound. Both Plasmodium vivax and Plasmodium falciparum malaria are associated with maternal and foetal morbidity and mortality [1,2]. Whether in-utero exposure to malaria has an effect on the growth and development of the foetal central nervous system is not known. Studying the pathophysiological consequences of malaria in pregnancy on the foetus has been complicated by was that foetuses affected by maternal malaria experience growth restriction, including smaller foetal brain volume and an accelerated cortical folding process
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