Malaria and pre-eclampsia in an area with unstable malaria transmission in Central Sudan

Ishag Adam,Magdi M Salih,Ahmed A Mohmmed,Elhassan M Elhassan,Mustafa I Elbashir

doi:10.1186/1475-2875-10-258

Ishag Adam, Magdi M Salih + Show 3 more

Open Access

https://doi.org/10.1186/1475-2875-10-258

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Abstract

BackgroundPlacental malaria and pre-eclampsia occur frequently in women in tropics and are leading causes of maternal and perinatal morbidities and mortality. Few data exist concerning the interaction between placental malaria and pre-eclampsia.MethodsA case control study was conducted in Medani Hospital, which locates in an area of unstable malaria transmission in Central Sudan. Case (N = 143) were women with pre-eclampsia, which was defined as systolic blood presure≥140 mm Hg or diastolic blood pressure ≥ 90 mm Hg and proteinuria. Controls were parturient women (N = 143) without any blood pressure values > 139/89 mm Hg or proteinuria. Obstetrical and medical characteristics were gathered from both groups through structured questionnaires. Placental histopathology examinations for malaria were performed.ResultsTwenty-eight (19.6%) vs. 16 (11.2%); P = 0.04 of the cases vs. controls, had placental malaria infections. Five (2%), 1 (2%) and 22 (28.0%) vs. 1, 2 and 13 of the placentae showed acute, chronic and past infection on histopathology examination in the two groups respectively, while 115 (80.4%) vs.127 (88.8%) of them showed no infection, P = 0.04. In multivariate analysis, while there were no associations between age, parity, educational level, lack of antenatal care, blood groups and body mass index and pre-eclampsia; family history of hypertension and placental malaria (OR = 2.3, 95% CI = 1.0-5.2; P = 0.04) were significantly associated with pre-eclampsia.ConclusionPlacental malaria was associated with pre-eclampsia. Further research is needed.

Highlights

Placental malaria and pre-eclampsia occur frequently in women in tropics and are leading causes of maternal and perinatal morbidities and mortality
Seasonal changes in the incidence of pre-eclampsia have been described in tropics, which are consistent with malaria transmission periods [6]
While women with family history of hypertension and those who had placental malaria infections were at higher risk of pre-eclampsia in multivariate analyses, primigravidae, lack of antenatal care and history of malaria in the index pregnancy were associated with preeclampsia in univariate analysis only

Summary

Introduction

Placental malaria and pre-eclampsia occur frequently in women in tropics and are leading causes of maternal and perinatal morbidities and mortality. Few data exist concerning the interaction between placental malaria and pre-eclampsia. Pre-eclampsia, one of the most common medical complications of pregnancy, it affects approximately 10% of all human births [1]. It is a leading cause of maternal mortality worldwide, as well as an important cause of perinatal mortality [2]. Pre-eclampsia and maternal malaria would be expected frequently to occur concurrently in malarious areas, their interaction on the health of the mother and her baby has been little studied [5].

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