Abstract
Malaria in pregnancy remains a major cause of infant mortality through its contribution to preterm delivery, low birth weight and intrauterine death. During a cross-sectional study of 983 mothers delivering in a secondary health care facility in Ibadan, southwestern Nigeria, an area of high malaria transmission, the effect of maternal and placental malaria parasitaemia on newborn anthropometry was evaluated. Malaria parasitemia was detected by microscopy of Giemsa stained thick blood smears. Placental, maternal and combined placental and maternal malaria parasitaemia rates at the time of delivery were 13.1%, 12.7% and 11.1% respectively. The geometric mean parasite densities in maternal and placental smears were significantly higher in primigravid mothers than others (p = 0.004 and 0.002 respectively). Low birth weight rate was higher among babies born to mothers with maternal parasitaemia compared to those without (8.0 % versus 6.3%, p < 0.05). The mean birth weight was lower in neonates of mothers with peripheral and placental parasitaemia by 138 g and 122 g (p = 0.01 and 0.02) respectively, while the respective difference was up to 168 g and 151 g among primigravidae (p = 0.03 and 0.04). Neonates of mothers with maternal and placental parasitaemia had a lower mean length than those without parasitaemia (48.2 vs 49.2cm, p = < 0.0001 and 48.5 vs 49.2cm p = 0.02 respectively). Occiptofrontal circumference and ponderal indices were not significantly affected by maternal malaria parasitaemia. Malaria in pregnancy results in symmetric foetal growth restriction and the effect is more marked among primigravid mothers.
Highlights
Malaria in pregnancy is of public health concern due to its adverse effects on the mother as well as the foetus
Malaria during pregnancy may result in preterm delivery, intrauterine growth restriction (IUGR), reduced length and low birth weight (LBW) or stillbirth
Though previous reports have emphasized that the greatest burden of malaria in pregnancy in terms of incidence and outcome is among the paucigravida, it has been increasingly recognized that women of higher gravidities, especially in areas of low transmission, are at risk [1]
Summary
Malaria in pregnancy is of public health concern due to its adverse effects on the mother as well as the foetus. Malaria during pregnancy may result in preterm delivery, intrauterine growth restriction (IUGR), reduced length and low birth weight (LBW) or stillbirth. Up to 20% of LBW in sub-Saharan Africa has been attributed to malaria in pregnancy and this figure represents 35% of preventable low birth weight in the region [1,3,4]. Malaria-induced LBW is reported to account for 62,000 to 363,000 infant deaths annually [1,5]. It is an important determinant of perinatal mortality. Malaria in pregnancy remains a major cause of infant mortality through its contribution to preterm delivery, low birth weight and intrauterine death. Conclusion: Malaria in pregnancy results in symmetric foetal growth restriction and the effect is more marked among primigravid mothers
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