Malaria Transmission and Fetal Growth

Abstract

SummaryIn view of the known relation between infection of the maternal circulation of the placenta with Plasmodium falciparum and impaired fetal growth a study was made of the effect on birth weights of a malaria eradication campaign in the British Solomon Islands. Mean birth weights rose substantially within months of starting antimalarial operations. The increases between 1969 and 1971 averaged 252 g in babies of primigravidae and 165 g in all babies. The proportion of babies with birth weights of less than 2,500 g fell by 8% overall and by 20% among babies of primigravidae. The adverse effect of malaria transmission on fetal growth was apparently reversible if transmission of infection in the community was interrupted up to as late as the third trimester of pregnancy. The beneficial effects of malaria eradication operations on infant survival, child development, and social attitudes in developing countries are discussed.

Malaria in pregnancy: the difficulties in measuring birthweight

“…Differences in birthweight are often used to compare the efficacy of interventions aimed to reduce the impact of malaria during pregnancy. 95 – 98 Such differences can clearly be affected by inaccuracies in measurement methods, and confounders such as those affecting gestational age or time of weighing. The reporting of birthweight and gestational age in maternal malaria studies can be improved.…”

Materno-Fetal Transmission of Pregnancy Malaria: An Immunoparasitological Study on 202 Parturients in Maputo

“…There was a high prevalence of anaemia in the children, unrelated to the maternal infection. LBW has been associated with maternal malaria infec tion [9,10,18], A slight difference was noted with more LBW newborns in parasitaemic mothers but the differ ence was not significant. In the Mozambican setting intra-uterine bacterial infections, resulting in puerperal endometritis-myometritis, have been shown to increase the risk of LBW birth by as much as ten times [Libombo, pers.…”

“…The great majority of malaria cases in the world occur in tropical Africa where the disease is esti mated to cause 0.5-1 million deaths per year [2], In Mozambique malaria constitutes one of the principal health problems. In 1975/1976 malaria prevalence was over 40%, but the situation has worsened due to the appearance of chloroquine resistance [3], One serious consequence of this is the deterioration of maternal and child health [1], Pregnant women are more affected by malaria than non-pregnant women both in types with few symptoms [4] and in types with more acute symptoms [5], The situation might be worsened by inadequate therapy and by a diminishing protective immunity [6,7], In many cases malaria is complicated by a serious maternal anaemia, above all in the second trimester [5,8], Malarial complications of the fetus comprise fetal loss and prema turity [4], retarded intra-uterine growth [9,10], decreased passage of IgG [7,9] and congenital malaria [ 1,[11][12][13][14][15], Placental malaria is described in the literature as an entity associated with an increase in placental surface parasitaemia [13] with associated tissular changes in the blood cell membrane and in the trophoblastic cells [9], There seems to be auto-agglutination and fibrine aggrega tion in the intervillous space with deposition of malarial pigment and mononuclear cell infiltration [16],…”

Challenges for malaria elimination in Brazil

“…Malaria infection during pregnancy is associated with substantial risks for the mother, her fetus, and the neonate. Stillbirth, intrauterine growth retardation, prematurity, low birth weight, spontaneous abortion, increased neonatal and maternal mortality, and reduced neurocognitive function later in childhood are documented complications of malaria in pregnancy (MiP) [ 139 , 140 ].…”