Abstract
The pathogenesis of malaria during pregnancy is not fully understood. A proinflammatory cytokine, macrophage migration inhibitory factor (MIF) is suggested as a factor involved in the pathogenesis of malaria during pregnancy. A cross-sectional study was conducted in Medani Hospital, Sudan to investigate MIF levels in placental malaria. Obstetrical and medical characteristics were gathered from each parturient woman using questionnaires. All women (151) were investigated for malaria using blood film and placental histology. MIF levels were measured using ELISA in paired maternal and cord blood samples. There were no P. falciparum-positive blood films obtained from maternal peripheral blood, placenta or cord samples. Out of 151 placentae, four (2.6%), one (0.7%), 32 (21.2%) showed acute, chronic and past infection on histopathology examinations respectively, while the rest (114; 75.5%) of them showed no signs of infection.There was no significant difference in the median (interquartile) of maternal [5.0 (3.7─8.8) vs 6.2(3.5─12.0) ng/ml, P=0.643] and cord [8.1(3.3─16.9) vs 8.3(4.2─16.9), ng/ml, P= 0.601] MIF levels between women with a positive result for placental malaria infection (n=37) and women with a negative result for placental malaria infection (n=114). In regression models placental malaria was not associated with maternal MIF, hemoglobin or birth weight. MIF was not associated with hemoglobin or birth weight . There was no association between maternal and cord MIF levels, placental malaria, maternal hemoglobin and birth weight.
Highlights
The pathogenesis of malaria during pregnancy is not fully understood
Malaria is associated with adverse pregnancy outcomes such as anemia[6] and LBW7, and it is the main cause of maternal mortality[8]
None of the investigated factors were associated with placental malaria infection, Table 2
Summary
The pathogenesis of malaria during pregnancy is not fully understood. A proinflammatory cytokine, macrophage migration inhibitory factor (MIF) is suggested as a factor involved in the pathogenesis of malaria during pregnancy. All women (151) were investigated for malaria using blood film and placental histology. In regression models placental malaria was not associated with maternal MIF, hemoglobin or birth weight. Conclusion: There was no association between maternal and cord MIF levels, placental malaria, maternal hemoglobin and birth weight. Malaria during pregnancy can lead to adverse outcomes (both maternal and perinatal) e.g. anemia and low birth weight (LBW)[2,3,4]. Malaria is associated with adverse pregnancy outcomes such as anemia[6] and LBW7, and it is the main cause of maternal mortality[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 LBW11
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