Abstract
BackgroundThe risk of Plasmodium falciparum malaria increases during pregnancy and at early postpartum. Immunological and physiological alterations associated with pregnancy that persist after delivery may contribute to the susceptibility to P. falciparum during early postpartum period.MethodsTo determine changes in antibody-mediated responses after pregnancy, levels of Immunoglobulin G (IgGs) specific for P. falciparum were compared in 200 pairs of plasmas collected from Mozambican women at delivery and during the first two months postpartum. IgGs against the surface of erythrocytes infected with a P. falciparum chondroitin sulphate A binding line (CS2) and a paediatric isolate (MOZ2) were measured by flow cytometry.ResultsIgG levels against CS2 and MOZ2 were higher at postpartum than at delivery (p = 0.033 and p = 0.045, respectively) in women without P. falciparum infection. The analysis stratified by parity and period after delivery showed that this increase was significant in multi-gravid women (p = 0.023 for CS2 and p = 0.054 for MOZ2) and during the second month after delivery (p = 0.018 for CS2 and p = 0.015 for MOZ2).ConclusionsThese results support the view that early postpartum is a period of recovery from physiological or immunological changes associated with pregnancy.
Highlights
The risk of Plasmodium falciparum malaria increases during pregnancy and at early postpartum
It has been speculated that the period of recovery from immunological and physiological alterations associated with pregnancy may still render puerperal women susceptible to malaria [3]
immunoglobulin G (IgG) levels at delivery and postpartum Levels of IgGs specific for CS2 and MOZ2 were higher at postpartum than at delivery in 115 (58 %) and 120 (60 %) of the 200 women, respectively (Table 2)
Summary
The risk of Plasmodium falciparum malaria increases during pregnancy and at early postpartum. Immunological and physiological alterations associated with pregnancy that persist after delivery may contribute to the susceptibility to P. falciparum during early postpartum period. The risk of Plasmodium falciparum malaria increases during pregnancy [2] and has been suggested to remain high at early postpartum compared to the same women during pregnancy [3] and to non-pregnant women [4]. Other studies have suggested that the rate of parasitaemia decreases after delivery and that women who were parasitaemic at delivery cleared their parasitaemia spontaneously at early postpartum [5,6]. It has been speculated that the period of recovery from immunological and physiological alterations associated with pregnancy may still render puerperal women susceptible to malaria [3]
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