Abstract

BackgroundThe pathophysiology of the placental malaria is not fully understood. If there is a fetal sex–specific susceptibility to malaria infection, this might add to the previous knowledge on the immunology, endocrinology and pathophysiology of placental malaria infections.AimsThis study was conducted to assess whether the sex of the fetus was associated with placental malaria infections.Subjects and methodsA cross-sectional study was performed including a secondary analysis of a cohort of women who were investigated for prevalence and risk factors (including fetal sex) for placental malaria in eastern Sudan. Placental histology was used to diagnose placental malaria infections.ResultsAmong 339 women enrolled, the mean (SD) age was 25.8 (6.7) years and parity was 2.7 (2.2). Among the new born babies, 157 (46.3%) were male and 182 (53.7%) were female. Five (1.5%), 9 (2.7%) and 103 (30.4%) of the 339 placentas had active, active-chronic, past-chronic malaria infection on histopathology examination respectively, while 222 (65.5%) of them showed no malaria infection. Logistic regression analyses showed no associations between maternal age or parity and placental malaria infections. Women who have blood group O (OR = 1.95, 95% CI = 1.19–3.10; P = 0.007) and women who had female new born were at higher risk for placental malaria infections (OR = 2.55, 95% CI = 1.57–4.13; P< 0.001).ConclusionFetal gender may be a novel risk factor for placental malaria. In this work the female placentas were at higher risk for malaria infections than the male placentas.

Highlights

  • There is a great in interest in recent years in the female/male distribution during pregnancy and its interaction with maternal and perinatal health [1]

  • Women who have blood group O (OR = 1.95, 95% CI = 1.19–3.10; P = 0.007) and women who had female new born were at higher risk for placental malaria infections (OR = 2.55, 95% CI = 1.57–4.13; P< 0.001)

  • In this work the female placentas were at higher risk for malaria infections than the male placentas

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Summary

Introduction

There is a great in interest in recent years in the female/male distribution during pregnancy and its interaction with maternal and perinatal health [1]. Plasmodium falciparum malaria infection during pregnancy is a major public health problem especially in sub-Saharan Africa, where it is a major cause of maternal and perinatal morbidity and mortality [9,10]. The pathophysiology of the placental malaria is not fully understood and the finding of the fetal sex–specific susceptibility of malaria infection might add to the previous knowledge on the immunology, endocrinology and pathophysiology of placental malaria infections. If there is a fetal sex– specific susceptibility to malaria infection, this might add to the previous knowledge on the immunology, endocrinology and pathophysiology of placental malaria infections. Editor: Claudio Romero Farias Marinho, Universidade de Sao Paulo Instituto de Ciencias Biomedicas, BRAZIL

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