Fetal growth restriction is associated with malaria in pregnancy: A prospective longitudinal study in Benin

TY - JOUR

T1 - Fetal growth restriction is associated with malaria in pregnancy

T2 - A prospective longitudinal study in Benin

AU - Briand, Valérie

AU - Saal, Jessica

AU - Ghafari, Caline

AU - Huynh, Bich-Tram

AU - Fievet, Nadine

AU - Schmiegelow, Christentze

AU - Massougbodji, Achille

AU - Deloron, Philippe

AU - Zeitlin, Jennifer

AU - Cot, Michel

N1 - © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail [email protected].

PY - 2016/8/1

Y1 - 2016/8/1

N2 - BACKGROUND: Few studies have evaluated the effect of malaria on intrauterine growth restriction on the basis of the fetal growth rate, rather than just the small-for-gestational age z score. Here, we assessed the impact of malaria on IUGR, using data from a longitudinal, ultrasonography-based follow-up study of Beninese women.METHODS: A total of 1016 women were followed up from gestational week 17 to delivery. Malaria was detected every month. Women underwent ultrasonography 4 times for gestational age determination and fetal biometry. We assessed the effect of malaria on birth weight-for-gestational age z score (n = 735 women) and fetal growth velocity (n = 664), defined as a change in fetal weight z score over time.RESULTS: Malaria was detected in 43% of women. Fetal growth velocity was negative overall, decreasing further at the end of the third trimester. Women with ≥2 malarial parasite infections tended to have lower z scores than uninfected women. Malaria both in early and late pregnancy was associated with a reduction in fetal growth velocity, which occurred either immediately or with a delay after infection.DISCUSSIONS: We confirmed the deleterious effect of malaria during both early and late pregnancy on fetal growth. This stresses the importance of starting preventive measures against malaria as early as possible during pregnancy.

AB - BACKGROUND: Few studies have evaluated the effect of malaria on intrauterine growth restriction on the basis of the fetal growth rate, rather than just the small-for-gestational age z score. Here, we assessed the impact of malaria on IUGR, using data from a longitudinal, ultrasonography-based follow-up study of Beninese women.METHODS: A total of 1016 women were followed up from gestational week 17 to delivery. Malaria was detected every month. Women underwent ultrasonography 4 times for gestational age determination and fetal biometry. We assessed the effect of malaria on birth weight-for-gestational age z score (n = 735 women) and fetal growth velocity (n = 664), defined as a change in fetal weight z score over time.RESULTS: Malaria was detected in 43% of women. Fetal growth velocity was negative overall, decreasing further at the end of the third trimester. Women with ≥2 malarial parasite infections tended to have lower z scores than uninfected women. Malaria both in early and late pregnancy was associated with a reduction in fetal growth velocity, which occurred either immediately or with a delay after infection.DISCUSSIONS: We confirmed the deleterious effect of malaria during both early and late pregnancy on fetal growth. This stresses the importance of starting preventive measures against malaria as early as possible during pregnancy.

U2 - 10.1093/infdis/jiw158

DO - 10.1093/infdis/jiw158

M3 - Journal article

C2 - 27389349

SN - 0022-1899

VL - 214

SP - 417

EP - 425

JO - The Journal of Infectious Diseases

JF - The Journal of Infectious Diseases

IS - 3

ER -