Elizabeth M McClure1, Steven R Meshnick2, Noam Lazebnik3, Peter Mungai4, Christopher L King4, Michael Hudgens5, Robert L Goldenberg6, Anna-Maria Siega-Riz2, Arlene E Dent4. 1. Social, Statistical and Environmental Sciences, Research Triangle Institute, Durham, USA; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, USA. Electronic address: mcclure@rti.org. 2. Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, USA. 3. Department of Obstetrics and Gynecology, University Hospital, Cleveland, USA. 4. Center for Global Health and Diseases, Case Western Reserve University, Cleveland, USA. 5. Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, USA. 6. Department of Obstetrics and Gynecology, Columbia University School of Medicine, New York, USA.
Abstract
OBJECTIVE: To use ultrasound to explore the impact of malaria in pregnancy on fetal growth and newborn outcomes among a cohort of women enrolled in an intermittent presumptive treatment in pregnancy (IPTp) with sulfadoxine/pyrimethamine (SP) program in coastal Kenya. METHODS: Enrolled women were tested for malaria at first prenatal care visit, and physical and ultrasound examinations were performed. In total, 477 women who had term, live births had malaria tested at delivery and their birth outcomes assessed, and were included in the study. RESULTS: Peripheral malaria was detected via polymerase chain reaction among 10.9% (n=87) at first prenatal care visit and 8.8% (n=36) at delivery. Insecticide-treated bed nets (ITNs) were used by 73.6% (n=583) and were associated with decreased malaria risk. There was a trend for impaired fetal growth and placental blood flow in malaria-infected women in the second trimester, but not later in pregnancy. Among women with low body mass index (BMI), malaria was associated with reduced birth weight (P=0.04); anthropometric measures were similar otherwise. CONCLUSION: With IPTp-SP and ITNs, malaria in pregnancy was associated with transient differences in utero, and reduced birth weight was restricted to those with low BMI.
OBJECTIVE: To use ultrasound to explore the impact of malaria in pregnancy on fetal growth and newborn outcomes among a cohort of women enrolled in an intermittent presumptive treatment in pregnancy (IPTp) with sulfadoxine/pyrimethamine (SP) program in coastal Kenya. METHODS: Enrolled women were tested for malaria at first prenatal care visit, and physical and ultrasound examinations were performed. In total, 477 women who had term, live births had malaria tested at delivery and their birth outcomes assessed, and were included in the study. RESULTS: Peripheral malaria was detected via polymerase chain reaction among 10.9% (n=87) at first prenatal care visit and 8.8% (n=36) at delivery. Insecticide-treated bed nets (ITNs) were used by 73.6% (n=583) and were associated with decreased malaria risk. There was a trend for impaired fetal growth and placental blood flow in malaria-infectedwomen in the second trimester, but not later in pregnancy. Among women with low body mass index (BMI), malaria was associated with reduced birth weight (P=0.04); anthropometric measures were similar otherwise. CONCLUSION: With IPTp-SP and ITNs, malaria in pregnancy was associated with transient differences in utero, and reduced birth weight was restricted to those with low BMI.
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