Effect of malaria in pregnancy on foetal cortical brain development: a longitudinal observational study

Rijken, Marcus J.; Wit, M.C. de; Mulder, E.J.H.; Kiricharoen, Suporn; Karunkonkowit, Noaeni; Paw, T. K.; Visser, Gerard H.A.; McGready, Rose; Nosten, François; Pistorius, Lourens R.

doi:10.1186/1475-2875-11-222

Cited by 13 publications

(12 citation statements)

References 13 publications

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“…Placental biopsies were collected between 2004–2011, from the Department of Tropical Pathology, Faculty of Tropical Medicine and three previously published studies investigating malaria in pregnancy conducted at Shoklo Malaria Research Unit (SMRU) field research station at Mae Sot, Thailand. These were studies of the histopathology of placental malaria, used to identify cases with acute infection at delivery with both P. falciparum and P. vivax [ 17 ], an observational ultrasound in pregnancy study (UPS) [ 18 , 19 ] and the artemether-lumefantrine treatment of malaria study (PCA) [ 20 , 21 ]. Women in these studies included ethnic Karen refugees and migrants from an area of approximately 120 km around the border between Thailand and Myanmar, surrounding the town of Mae Sot and the Maela refugee camp.…”

Section: Methodsmentioning

confidence: 99%

A morphometric and histological study of placental malaria shows significant changes to villous architecture in both Plasmodium falciparum and Plasmodium vivax infection

Chaikitgosiyakul

Rijken

Muehlenbachs

et al. 2014

Malar J

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BackgroundMalaria in pregnancy remains a major health problem. Placental malaria infection may cause pathophysiological changes in pregnancy and result in morphological changes to placental villi. Quantitative histomorphological image analysis of placental biopsies was performed to compare placental villous architecture between active or treated placental malaria cases and controls.MethodsA total of 67 placentas were studied from three clinical groups: control patients who did not have malaria (n = 27), active (n = 14) and treated (n=26) malaria cases, including both Plasmodium falciparum and Plasmodium vivax infections. Image analysis of histological placental sections was performed using ImageJ software to measure the number and size (area) of terminal villi, perimeter measurement per villus and total perimeter per unit area, and number of capillaries per villus (vascularity). Histological features of placental malaria were scored and these results were correlated with malaria status and clinical outcomes.ResultsVillous size correlated with vascularity (p <0.0001) but was inversely correlated with observed villi per unit area, (p = 0.0001). Significantly greater villous area and vascularity was observed in UK controls. Indices of histological malaria infection were significantly greater in active versus treated malaria cases. Active placental malaria cases showed significantly smaller villous area (p <0.0084), vascularity (p <0.0139) and perimeter (p <0.0006) than treated malaria cases or controls, but significantly more villi per unit area (p <0.0001). Villous size in treated malaria cases was significantly larger than active placental malaria cases (p <0.001) and similar to controls. There was a significant relationship between villous number and anaemia at the time of infection (p <0.0034), but not placental weight, birth weight or gestational age at delivery. No differences were found between histology or villous morphology comparing infections with P. falciparum or P. vivax.ConclusionsThese results imply that villous size, perimeter and vascularity are acutely decreased during active placental malaria, decreasing the surface area available for gas exchange per villus. However the increased number of villi per unit area offsets this change and persists after treatment. Histopathological and villous architectural changes may be reversed by early detection and appropriate anti-malarial treatment.

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Section: Methodsmentioning

confidence: 99%

A morphometric and histological study of placental malaria shows significant changes to villous architecture in both Plasmodium falciparum and Plasmodium vivax infection

Chaikitgosiyakul

Rijken

Muehlenbachs

et al. 2014

Malar J

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“… 1 In addition, in utero exposure to malaria parasites has been associated with a decreased head circumference (HC) among fetuses and newborns, a proportional decrease in size as an outcome of the intrauterine growth retardation. 3 , 4 , 5 , 6 …”

Section: Introductionmentioning

confidence: 99%

Association of Malaria Infection During Pregnancy With Head Circumference of Newborns in the Brazilian Amazon

et al. 2019

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Key Points Question Is malaria infection during pregnancy associated with fetal head growth? Findings In 2 cohort studies of 4291 pregnancies, falciparum malaria during pregnancy was significantly associated with the occurrence of decreased head circumference in newborns. Placental malaria characterized by increased placental syncytial nuclear aggregates, leukocyte infiltration, and imbalanced angiogenic factors was associated with the incidence of decreased head circumference. Meaning Plasmodium falciparum infection during pregnancy was associated with altered fetal head development, with possible consequences for fetal neurologic development.

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“…Studies on adults in Vietnam and children in Malawi have shown reduced expression of tight-junction proteins in fatal CM [6,97]. However, the studies showed no effect of MiP on fetal cortical development or supratentorial volume, except that the cingulate gyrus matured comparatively faster [6,98,99]. Hyperthermia is one of the common symptoms of malaria, and research has shown that maternal hyperthermia in their early stage of the first trimester of pregnancy is associated with increased risk of neural tube defects and may act as a human teratogen [100].…”

Section: Effect Of Mip On Fetal Neurodevelopmentmentioning

confidence: 99%

Effects of Malaria in Pregnancy (MiP) on Pregnancy Development and its Outcome: a Critical Review

Djabanor¹,

Quansah²,

DuBois³

2017

J App Biol Biotech

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Malaria is the most important tropical parasitic infection in humans all over the world, and very common in developing countries especially in the tropical zones. The protozoan parasites Plasmodium falciparum, P. vivax, P. malariae and P. ovaleare transmitted through the bite of sporozoite-infected female Anopheles mosquitoes to cause malaria in humans. Malaria in pregnancy (MiP) is a clinical situation in which a pregnant woman is infected with Plasmodium parasite resulting in malaria. MiP is detrimental to both the pregnant woman and her fetus, and it remains as one of the major causes of infant mortality in malaria endemic regions especially in Sub-Saharan Africa. It causes several histopathological changes within the placenta and umbilical cord which manifest in several clinical symptoms. It is one of the key contributors to preterm delivery, low birth weight, intrauterine growth retardation (IUGR), miscarriage, intrauterine death, poor neurodevelopment and immunosuppression in infants. Most distinct systemic proinflammatory responses in pregnancy are characteristics of severe malaria, and excessive activation of the immune system is central to the pathophysiology of placental malaria. There is extensive research on VAR2CSA and its contribution to placental sequestration. Currently, VAR2CSA protein is being made into pregnancy malaria specific vaccines for non-immune mothers to reduce placental malaria infection. This review summarizes the evidences, currently known clinically significant manifestations and the ultimate effect of MiP on pregnancy development.

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Effect of malaria in pregnancy on foetal cortical brain development: a longitudinal observational study

Cited by 13 publications

References 13 publications

A morphometric and histological study of placental malaria shows significant changes to villous architecture in both Plasmodium falciparum and Plasmodium vivax infection

A morphometric and histological study of placental malaria shows significant changes to villous architecture in both Plasmodium falciparum and Plasmodium vivax infection

Association of Malaria Infection During Pregnancy With Head Circumference of Newborns in the Brazilian Amazon

Effects of Malaria in Pregnancy (MiP) on Pregnancy Development and its Outcome: a Critical Review

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