Plasmodium falciparum infection early in pregnancy has profound consequences for fetal growth

Christentze Schmiegelow; Sungwa Matondo; Daniel T R Minja; Mafalda Resende; Caroline Pehrson; Birgitte Bruun Nielsen; Raimos Olomi; Morten A Nielsen; Philippe Deloron; Ali Salanti; John Lusingu; Thor G Theander

doi:10.1093/infdis/jix530

Plasmodium falciparum infection early in pregnancy has profound consequences for fetal growth

Christentze Schmiegelow, Sungwa Matondo, Daniel T R Minja, Mafalda Resende, Caroline Pehrson, Birgitte Bruun Nielsen, Raimos Olomi, Morten A Nielsen, Philippe Deloron, Ali Salanti, John Lusingu, Thor G Theander

13 Citationer (Scopus)

Abstract

Malaria during pregnancy constitutes a large health problem in areas of endemicity. The World Health Organization recommends that interventions are initiated at the first antenatal visit, and these improve pregnancy outcomes. This study evaluated fetal growth by ultrasonography and birth outcomes in women who were infected prior to the first antenatal visit (gestational age, <120 days) and not later in pregnancy. Compared with uninfected controls, women with early Plasmodium falciparum exposure had retarded intrauterine growth between gestational ages of 212 and 253 days (difference between means, 107 g [95% confidence interval {CI}, 26-188]; P = .0099) and a shorter pregnancy duration (difference between means, 6.6 days [95% CI, 1.0-112.5]; P = .0087). The birth weight (difference between means, 221 g [95% CI, 6-436]; P = .044) and the placental weight (difference between means, 84 g [95% CI, 18-150]; P = .013) at term were also reduced. The study suggests that early exposure to P. falciparum, which is not targeted for prevention by current control strategies, has a profound impact on fetal growth, pregnancy duration, and placental weight at term.

Originalsprog	Engelsk
Tidsskrift	The Journal of Infectious Diseases
Vol/bind	216
Udgave nummer	12
Sider (fra-til)	1601-1610
Antal sider	10
ISSN	0022-1899
DOI	https://doi.org/10.1093/infdis/jix530
Status	Udgivet - 15 dec. 2017

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https://academic.oup.com/jid/article-pdf/216/12/1601/22924301/jix530.pdf

Citationsformater

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title = "Plasmodium falciparum infection early in pregnancy has profound consequences for fetal growth",

abstract = "Malaria during pregnancy constitutes a large health problem in areas of endemicity. The World Health Organization recommends that interventions are initiated at the first antenatal visit, and these improve pregnancy outcomes. This study evaluated fetal growth by ultrasonography and birth outcomes in women who were infected prior to the first antenatal visit (gestational age, <120 days) and not later in pregnancy. Compared with uninfected controls, women with early Plasmodium falciparum exposure had retarded intrauterine growth between gestational ages of 212 and 253 days (difference between means, 107 g [95% confidence interval {CI}, 26-188]; P = .0099) and a shorter pregnancy duration (difference between means, 6.6 days [95% CI, 1.0-112.5]; P = .0087). The birth weight (difference between means, 221 g [95% CI, 6-436]; P = .044) and the placental weight (difference between means, 84 g [95% CI, 18-150]; P = .013) at term were also reduced. The study suggests that early exposure to P. falciparum, which is not targeted for prevention by current control strategies, has a profound impact on fetal growth, pregnancy duration, and placental weight at term.",

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AU - Schmiegelow, Christentze

AU - Matondo, Sungwa

AU - Minja, Daniel T R

AU - Resende, Mafalda

AU - Pehrson, Caroline

AU - Nielsen, Birgitte Bruun

AU - Olomi, Raimos

AU - Nielsen, Morten A

AU - Deloron, Philippe

AU - Salanti, Ali

AU - Lusingu, John

AU - Theander, Thor G

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N2 - Malaria during pregnancy constitutes a large health problem in areas of endemicity. The World Health Organization recommends that interventions are initiated at the first antenatal visit, and these improve pregnancy outcomes. This study evaluated fetal growth by ultrasonography and birth outcomes in women who were infected prior to the first antenatal visit (gestational age, <120 days) and not later in pregnancy. Compared with uninfected controls, women with early Plasmodium falciparum exposure had retarded intrauterine growth between gestational ages of 212 and 253 days (difference between means, 107 g [95% confidence interval {CI}, 26-188]; P = .0099) and a shorter pregnancy duration (difference between means, 6.6 days [95% CI, 1.0-112.5]; P = .0087). The birth weight (difference between means, 221 g [95% CI, 6-436]; P = .044) and the placental weight (difference between means, 84 g [95% CI, 18-150]; P = .013) at term were also reduced. The study suggests that early exposure to P. falciparum, which is not targeted for prevention by current control strategies, has a profound impact on fetal growth, pregnancy duration, and placental weight at term.

AB - Malaria during pregnancy constitutes a large health problem in areas of endemicity. The World Health Organization recommends that interventions are initiated at the first antenatal visit, and these improve pregnancy outcomes. This study evaluated fetal growth by ultrasonography and birth outcomes in women who were infected prior to the first antenatal visit (gestational age, <120 days) and not later in pregnancy. Compared with uninfected controls, women with early Plasmodium falciparum exposure had retarded intrauterine growth between gestational ages of 212 and 253 days (difference between means, 107 g [95% confidence interval {CI}, 26-188]; P = .0099) and a shorter pregnancy duration (difference between means, 6.6 days [95% CI, 1.0-112.5]; P = .0087). The birth weight (difference between means, 221 g [95% CI, 6-436]; P = .044) and the placental weight (difference between means, 84 g [95% CI, 18-150]; P = .013) at term were also reduced. The study suggests that early exposure to P. falciparum, which is not targeted for prevention by current control strategies, has a profound impact on fetal growth, pregnancy duration, and placental weight at term.

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DO - 10.1093/infdis/jix530

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SN - 0022-1899

VL - 216

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JO - The Journal of Infectious Diseases

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Plasmodium falciparum infection early in pregnancy has profound consequences for fetal growth

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