Abstract
BACKGROUND: The influence of gravidity on placental parasitaema was studied in the University of Port Harcourt teaching hospital. Because Immunity is acquired over successive pregnancies, susceptibility to malaria is greatest during the first pregnancy and diminishes with increasing gravidity. Similarly, placenta inflammation and the sequelae of pregnancy malaria, such as severe maternal anemia and low birth weight, are most frequent during first pregnancies. METHODOLOGY: Blood samples of the neonates, placenta, cord and the mothers were taken and malaria rapid immunodiagnostic tests were carried out using Plasmodium falciparum rapid test device. Tick films were examined microscopically for malaria parasite using oil immersion objective. Twenty six mothers and their placenta as well as the accompanying umbilical cord and 26 neonates were studied. RESULT: The prevalence of placental malaria that lead to symptomatic first parasitamia significantly decreased as the gravidity increased (X2=15.99,P 0.001). Infants born from primigravidae were significantly more likely to be infected with P. falciparum(X2=6.45 P 0.001) as compared to infants born from multigravidae. CONCLUSION: Immunity to malaria is lowest in primigravids, hence greater prevalence of placental inflammation and the sequel of pregnancy malaria, and associated complications.
Highlights
The hallmark of pregnancy malaria due to Plasmodium falciparum is the accumulation of infected erythrocytes (IEs) in the placenta[5]
Adhesion to chondroitin sulfate A (CSA) allows parasites to sequester in the placenta, where dense accumulations can often occur with li ttle or no parasitaemia detectable in the peripheral blood and because CSA-binding parasites do not commonly infect non-pregnant individual, women usually lack immunity to this parasite form prior to the first pregnancy[3,1,4]
Because Immunity is acquired over successive pregnancies, susceptibility to malaria is greatest during the first pregnancy and diminishes with increasing gravidity
Summary
The hallmark of pregnancy malaria due to Plasmodium falciparum is the accumulation of infected erythrocytes (IEs) in the placenta[5]. In areas of stable malaria transmission, women acquire maternal antibodies against placental IEs parasites over successive pregnancies as a consequence of repeated exposures These are associated with reduced risk of maternal parasitaemia and improved pregnancy outcomes[4,12,2]. Pregnancy malaria is estimated to cause tens of thousands or hundreds of thousands of infant deaths each year These estimates are extrapolated from the incidence of malaria-related outcomes such as low birth weight and maternal anemia that increase infant mortality risk[7,6]. This present study, seeks to investigate the prevalence of placental malaria in University of Port Harcourt Teaching Hospital and to determine the influence of parity on placental malaria prevalence. It has been shown that placental parasitaemia that can lead to pregnancy malaria is prevalent in this region and that parity is a key determinant
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