Clinical outcomes of submicroscopic infections and correlates of protection of VAR2CSA antibodies in a longitudinal study of pregnant women in Colombia

Kenneth Gavina; Sedami Gnidehou; Eliana Arango; Chloe Hamel-Martineau; Catherine Mitran; Olga Agudelo; Carolina Lopez; Aisha Karidio; Shanna Banman; Jaime Carmona-Fonseca; Ali Salanti; Nicaise Tuikue Ndam; Michael Hawkes; Amanda Maestre; Stephanie K Yanow

doi:10.1128/iai.00797-17

Clinical outcomes of submicroscopic infections and correlates of protection of VAR2CSA antibodies in a longitudinal study of pregnant women in Colombia

Kenneth Gavina, Sedami Gnidehou, Eliana Arango, Chloe Hamel-Martineau, Catherine Mitran, Olga Agudelo, Carolina Lopez, Aisha Karidio, Shanna Banman, Jaime Carmona-Fonseca, Ali Salanti, Nicaise Tuikue Ndam, Michael Hawkes, Amanda Maestre, Stephanie K Yanow

8 Citationer (Scopus)

Abstract

Malaria in pregnancy can cause serious adverse outcomes for the mother and the fetus. However, little is known about the effects of submicroscopic infections (SMIs) in pregnancy, particularly in areas wherePlasmodium falciparumandPlasmodium vivaxcocirculate. A cohort of 187 pregnant women living in Puerto Libertador in northwest Colombia was followed longitudinally from recruitment to delivery. Malaria was diagnosed by microscopy, reverse transcription-quantitative PCR (RT-qPCR), and placental histopathology. Gestational age, hemoglobin concentration, VAR2CSA-specific IgG levels, and adhesion-blocking antibodies were measured during pregnancy. Statistical analyses were performed to evaluate the impact of SMIs on birth weight and other delivery outcomes. Twenty-five percent of women (45/180) were positive for SMIs during pregnancy. Forty-seven percent of infections (21/45) were caused byP. falciparum, 33% were caused byP. vivax, and 20% were caused by mixedPlasmodiumspp. Mixed infections ofP. falciparumandP. vivaxwere associated with lower gestational age at delivery (P= 0.0033), while other outcomes were normal. Over 60% of women had antibodies to VAR2CSA, and there was no difference in antibody levels between those with and without SMIs. The anti-adhesion function of these antibodies was associated with protection from SMI-related anemia at delivery (P= 0.0086). SMIs occur frequently during pregnancy, and while mixed infections of bothP. falciparumandP. vivaxwere not associated with a decrease in birth weight, they were associated with significant risk of preterm birth. We propose that the lack of adverse delivery outcomes is due to functional VAR2CSA antibodies that can protect pregnant women from SMI-related anemia.

Originalsprog	Engelsk
Artikelnummer	e00797-17
Tidsskrift	Infection and Immunity
Vol/bind	86
Udgave nummer	4
ISSN	0019-9567
DOI	https://doi.org/10.1128/iai.00797-17
Status	Udgivet - 1 apr. 2018

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Correction for Gavina et al., “Clinical Outcomes of Submicroscopic Infections and Correlates of Protection of VAR2CSA Antibodies in a Longitudinal Study of Pregnant Women in Colombia”

Citationsformater

Gavina, K., Gnidehou, S., Arango, E., Hamel-Martineau, C., Mitran, C., Agudelo, O., Lopez, C., Karidio, A., Banman, S., Carmona-Fonseca, J., Salanti, A., Tuikue Ndam, N., Hawkes, M., Maestre, A., & Yanow, S. K. (2018). Clinical outcomes of submicroscopic infections and correlates of protection of VAR2CSA antibodies in a longitudinal study of pregnant women in Colombia. Infection and Immunity, 86(4), [e00797-17]. https://doi.org/10.1128/iai.00797-17

Gavina, K, Gnidehou, S, Arango, E, Hamel-Martineau, C, Mitran, C, Agudelo, O, Lopez, C, Karidio, A, Banman, S, Carmona-Fonseca, J, Salanti, A, Tuikue Ndam, N, Hawkes, M, Maestre, A & Yanow, SK 2018, 'Clinical outcomes of submicroscopic infections and correlates of protection of VAR2CSA antibodies in a longitudinal study of pregnant women in Colombia', Infection and Immunity, bind 86, nr. 4, e00797-17. https://doi.org/10.1128/iai.00797-17

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title = "Clinical outcomes of submicroscopic infections and correlates of protection of VAR2CSA antibodies in a longitudinal study of pregnant women in Colombia",

abstract = "Malaria in pregnancy can cause serious adverse outcomes for the mother and the fetus. However, little is known about the effects of submicroscopic infections (SMIs) in pregnancy, particularly in areas wherePlasmodium falciparumandPlasmodium vivaxcocirculate. A cohort of 187 pregnant women living in Puerto Libertador in northwest Colombia was followed longitudinally from recruitment to delivery. Malaria was diagnosed by microscopy, reverse transcription-quantitative PCR (RT-qPCR), and placental histopathology. Gestational age, hemoglobin concentration, VAR2CSA-specific IgG levels, and adhesion-blocking antibodies were measured during pregnancy. Statistical analyses were performed to evaluate the impact of SMIs on birth weight and other delivery outcomes. Twenty-five percent of women (45/180) were positive for SMIs during pregnancy. Forty-seven percent of infections (21/45) were caused byP. falciparum, 33% were caused byP. vivax, and 20% were caused by mixedPlasmodiumspp. Mixed infections ofP. falciparumandP. vivaxwere associated with lower gestational age at delivery (P= 0.0033), while other outcomes were normal. Over 60% of women had antibodies to VAR2CSA, and there was no difference in antibody levels between those with and without SMIs. The anti-adhesion function of these antibodies was associated with protection from SMI-related anemia at delivery (P= 0.0086). SMIs occur frequently during pregnancy, and while mixed infections of bothP. falciparumandP. vivaxwere not associated with a decrease in birth weight, they were associated with significant risk of preterm birth. We propose that the lack of adverse delivery outcomes is due to functional VAR2CSA antibodies that can protect pregnant women from SMI-related anemia.",

author = "Kenneth Gavina and Sedami Gnidehou and Eliana Arango and Chloe Hamel-Martineau and Catherine Mitran and Olga Agudelo and Carolina Lopez and Aisha Karidio and Shanna Banman and Jaime Carmona-Fonseca and Ali Salanti and {Tuikue Ndam}, Nicaise and Michael Hawkes and Amanda Maestre and Yanow, {Stephanie K}",

note = "Copyright {\textcopyright} 2018 American Society for Microbiology.",

year = "2018",

month = apr,

day = "1",

doi = "10.1128/iai.00797-17",

language = "English",

volume = "86",

journal = "Infection and Immunity",

issn = "0019-9567",

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TY - JOUR

T1 - Clinical outcomes of submicroscopic infections and correlates of protection of VAR2CSA antibodies in a longitudinal study of pregnant women in Colombia

AU - Gavina, Kenneth

AU - Gnidehou, Sedami

AU - Arango, Eliana

AU - Hamel-Martineau, Chloe

AU - Mitran, Catherine

AU - Agudelo, Olga

AU - Lopez, Carolina

AU - Karidio, Aisha

AU - Banman, Shanna

AU - Carmona-Fonseca, Jaime

AU - Salanti, Ali

AU - Tuikue Ndam, Nicaise

AU - Hawkes, Michael

AU - Maestre, Amanda

AU - Yanow, Stephanie K

PY - 2018/4/1

Y1 - 2018/4/1

N2 - Malaria in pregnancy can cause serious adverse outcomes for the mother and the fetus. However, little is known about the effects of submicroscopic infections (SMIs) in pregnancy, particularly in areas wherePlasmodium falciparumandPlasmodium vivaxcocirculate. A cohort of 187 pregnant women living in Puerto Libertador in northwest Colombia was followed longitudinally from recruitment to delivery. Malaria was diagnosed by microscopy, reverse transcription-quantitative PCR (RT-qPCR), and placental histopathology. Gestational age, hemoglobin concentration, VAR2CSA-specific IgG levels, and adhesion-blocking antibodies were measured during pregnancy. Statistical analyses were performed to evaluate the impact of SMIs on birth weight and other delivery outcomes. Twenty-five percent of women (45/180) were positive for SMIs during pregnancy. Forty-seven percent of infections (21/45) were caused byP. falciparum, 33% were caused byP. vivax, and 20% were caused by mixedPlasmodiumspp. Mixed infections ofP. falciparumandP. vivaxwere associated with lower gestational age at delivery (P= 0.0033), while other outcomes were normal. Over 60% of women had antibodies to VAR2CSA, and there was no difference in antibody levels between those with and without SMIs. The anti-adhesion function of these antibodies was associated with protection from SMI-related anemia at delivery (P= 0.0086). SMIs occur frequently during pregnancy, and while mixed infections of bothP. falciparumandP. vivaxwere not associated with a decrease in birth weight, they were associated with significant risk of preterm birth. We propose that the lack of adverse delivery outcomes is due to functional VAR2CSA antibodies that can protect pregnant women from SMI-related anemia.

AB - Malaria in pregnancy can cause serious adverse outcomes for the mother and the fetus. However, little is known about the effects of submicroscopic infections (SMIs) in pregnancy, particularly in areas wherePlasmodium falciparumandPlasmodium vivaxcocirculate. A cohort of 187 pregnant women living in Puerto Libertador in northwest Colombia was followed longitudinally from recruitment to delivery. Malaria was diagnosed by microscopy, reverse transcription-quantitative PCR (RT-qPCR), and placental histopathology. Gestational age, hemoglobin concentration, VAR2CSA-specific IgG levels, and adhesion-blocking antibodies were measured during pregnancy. Statistical analyses were performed to evaluate the impact of SMIs on birth weight and other delivery outcomes. Twenty-five percent of women (45/180) were positive for SMIs during pregnancy. Forty-seven percent of infections (21/45) were caused byP. falciparum, 33% were caused byP. vivax, and 20% were caused by mixedPlasmodiumspp. Mixed infections ofP. falciparumandP. vivaxwere associated with lower gestational age at delivery (P= 0.0033), while other outcomes were normal. Over 60% of women had antibodies to VAR2CSA, and there was no difference in antibody levels between those with and without SMIs. The anti-adhesion function of these antibodies was associated with protection from SMI-related anemia at delivery (P= 0.0086). SMIs occur frequently during pregnancy, and while mixed infections of bothP. falciparumandP. vivaxwere not associated with a decrease in birth weight, they were associated with significant risk of preterm birth. We propose that the lack of adverse delivery outcomes is due to functional VAR2CSA antibodies that can protect pregnant women from SMI-related anemia.

UR - https://iai.asm.org/content/86/8/e00366-18

U2 - 10.1128/iai.00797-17

DO - 10.1128/iai.00797-17

M3 - Journal article

C2 - 29378797

SN - 0019-9567

VL - 86

JO - Infection and Immunity

JF - Infection and Immunity

IS - 4

M1 - e00797-17

ER -

Clinical outcomes of submicroscopic infections and correlates of protection of VAR2CSA antibodies in a longitudinal study of pregnant women in Colombia

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