Malaria during pregnancy and its effects on foetus in a tribal area of Koraput District, Orissa.

Malaria during pregnancy and its maternal and foetal complications was studied in Koraput district of Orissa--a tribal area, endemic for malaria. A total of 209 pregnant women with 738 pregnancy months were studied. The parasitic index among the pregnant women ranged between 10.8 and 25.6 per cent with peak incidence during post-monsoon months. There was a significant difference in parasite incidence between the primi- and multigravidae (p < 0.05) but difference was not observed between the trimesters. The mean haemoglobin (Hb) concentration declined to 8.4 g/dl (range 7.2-10.2 g/dl) at full-term and parturition from its initial level of 9.6 g/dl (range 7.2-12.8 g/dl). There was a significant difference (p < 0.05) in Hb concentration among the trimesters of pregnancy. There was no significant difference in the outcome of pregnancies in women with or without malaria prarasites in their peripheral blood. There was no significant difference in Hb concentrations between malaria parasite positive and negative pregnant women (p > 0.05). Significant difference was observed in the proportion of newborn positives from mothers with or without malaria parasites indicating a high degree of transplacental transmission. The overall foetal mortality rate was 21.5 per cent. The miscarriage, stillbirth, premature delivery leading to foetal and neonatal along with perinatal mortality constituted for 24.4, 13.3, 20 and 17.7 per cent of all mortalities respectively.