Malaria During Pregnancy: Neonatal Morbidity and Mortality and the Efficacy of Chloroquine Chemoprophylaxis
Abstract
In malaria-endemic regions, the impact of malaria upon pregnancy and the value of chemoprophylaxis for malaria for pregnant women remain controversial. We prospectively studied 302 pregnant women who presented in labor to Centre Médical Evangélique, Nyankunde, Zaire. We evaluated the incidence of malarial infection in mothers, placentas, and neonates and examined the effect of infection on birth weight and perinatal mortality. We analyzed the outcome of pregnancy in relation to prophylaxis with chloroquine, controlling for parity and prenatal clinic attendance. Peripartum smears of maternal blood (21%), placentas (33%), cord blood (9%), and neonatal blood (7%) were positive for Plasmodium falciparum. Maternal malaria increased the risk of perinatal death (relative risk [RR] = 12.4) and low birth weight (RR = 3.7). Neonatal malaria increased the risk of perinatal death (RR = 7.2). Chloroquine prophylaxis protected against maternal (RR = 0.4) and fetal malaria (RR = 0.2), low birth weight (RR = 0.39), and perinatal death (RR = 0.38). Peripartum malaria increases the risk of perinatal death and low birth weight. Chemoprophylaxis with chloroquine during pregnancy may have a protective effect, even in certain areas where chloroquine-resistant P. falciparum is endemic.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Similar to placental blood smear, placental histology is more sensitive than peripheral blood smear for detecting pregnancy malaria.
“Similar to placental BS, placental histology is more sensitive than peripheral BS for detecting PM (33 vs 21%, respectively, and 52.5 vs 17.4%, respectively) [67,68].”
From Diagnosing malaria in pregnancy: An update (2012) · cites this paper as [67]
Cites
Estimation of a Common Effect Parameter from Sparse Follow-Up Data
Greenland, S., & Robins, J. M. (1985) · Biometrics · doi:10.2307/2530643 · Cited by 798 · see citing works
McGregor, I. A., Wilson, M. E., & Billewicz, W. Z. (1983) · Transactions of the Royal Society of Tropical Medicine and Hygiene · doi:10.1016/0035-9203(83)90081-0 · Cited by 399 · see citing works
Malaria in African Infants and Children in Southern Nigeria
Bruce-Chwatt, L. J. (1952) · Annals of Tropical Medicine and Parasitology · doi:10.1080/00034983.1952.11685522 · Cited by 299 · see citing works
Greenwood, B. M., Greenwood, A. M., Snow, R. W., Byass, P., Bennett, S. C. J., & N'jie, A. B. H. (1989) · Transactions of the Royal Society of Tropical Medicine and Hygiene · doi:10.1016/0035-9203(89)90362-3 · Cited by 152 · see citing works
Plasmodial pigmentation of placenta and outcome of pregnancy in West African mothers.
Watkinson, M., & Rushton, D. I. (1983) · BMJ · doi:10.1136/bmj.287.6387.251 · Cited by 102 · see citing works
Galbraith, R. M., Faulk, W. P., Galbraith, G. M. P., Holbrook, T. W., & Bray, R. S. (1980) · Transactions of the Royal Society of Tropical Medicine and Hygiene · doi:10.1016/0035-9203(80)90011-5 · Cited by 59 · see citing works
Brabin, B. J., Ginny, M., Alpers, M., Brabin, L., Eggelte, T., & Van Der Kaay, H. J. (1990) · Annals of Tropical Medicine & Parasitology · doi:10.1080/00034983.1990.11812428 · Cited by 58 · see citing works
Malaria Transmission and Fetal Growth
Macgregor, J. D., & Avery, J. G. (1974) · BMJ · doi:10.1136/bmj.3.5928.433 · Cited by 52 · see citing works
Anaemia in parturient women, with special reference to malaria infection of the placenta
Jilly, P. N. (1969) · Annals of Tropical Medicine and Parasitology · doi:10.1080/00034983.1969.11686605 · Cited by 43 · see citing works
Congenital malaria in Papua New Guinea
Lehner, P. J., & Andrews, C. J. A. (1988) · Transactions of the Royal Society of Tropical Medicine and Hygiene · doi:10.1016/0035-9203(88)90006-5 · Cited by 41 · see citing works
Paluku, K. M., Breman, J. G., Moore, M., et al. (1988) · Transactions of the Royal Society of Tropical Medicine and Hygiene · doi:10.1016/0035-9203(88)90113-7 · Cited by 23 · see citing works
Spencer, H. C., Kaseje, D., Sempebwa, E. K. N., Huong, A. Y., & Roberts, J. M. (1987) · Annals of Tropical Medicine and Parasitology · doi:10.1080/00034983.1987.11812192 · Cited by 21 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Epidemiology and burden of malaria in pregnancy
Desai, M., ter Kuile, F. O., Nosten, F., McGready, R., Asamoa, K., Brabin, B., & Newman, R. D. (2007) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(07)70021-x · Cited by 1,432 · see citing works
Moore, K. A., Simpson, J. A., Scoullar, M. J. L., McGready, R., & Fowkes, F. J. I. (2017) · The Lancet Global Health · doi:10.1016/s2214-109x(17)30340-6 · Cited by 165 · see citing works
Kattenberg, J. H., Ochodo, E. A., Boer, K. R., Schallig, H. D., Mens, P. F., & Leeflang, M. M. (2011) · Malaria Journal · doi:10.1186/1475-2875-10-321 · Cited by 138 · see citing works
Impact of Malaria at the End of Pregnancy on Infant Mortality and Morbidity
Bardají, A., Sigauque, B., Sanz, S., Maixenchs, M., Ordi, J., Aponte, J. J., Mabunda, S., Alonso, P. L., & Menéndez, C. (2011) · The Journal of Infectious Diseases · doi:10.1093/infdis/jiq049 · Cited by 136 · see citing works
Diagnosing malaria in pregnancy: An update
Fried, M., Muehlenbachs, A., & Duffy, P. E. (2012) · Expert Review of Anti-infective Therapy · doi:10.1586/eri.12.98 · Cited by 80 · see citing works
Malaria in pregnancy: adverse pregnancy outcomes and the future of prevention
Berhe, A. D., Doritchamou, J. Y. A., & Duffy, P. E. (2023) · Frontiers in Tropical Diseases · doi:10.3389/fitd.2023.1229735 · Cited by 30 · see citing works
- Authors
- Nyirjesy, P., Kavasya, T., Axelrod, P., & Fischer, P. R.
- Affiliations
- Mubende Hospital (UG)
- Corresponding author
- Nyirjesy, P.
- Venue
- Clinical Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 1993-01-01
- Volume
- 16
- Issue
- 1
- Pages
- 127-132
- ISSN
- 1058-4838 (ISSN-L)
- 1537-6591
- OpenAlex
- W2136293929
- Cited by
- 76
- References
- 12
- Citations by year
- 2026: 2 · 2025: 1 · 2023: 2 · 2022: 1 · 2021: 1 · 2019: 1 · 2018: 3 · 2017: 1 · 2016: 2 · 2014: 3 · 2013: 2 · 2012: 3
- FWCI
- 3.15
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Infectious Diseases (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Malaria Research and Control
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
- Health Sciences › Medicine › Genetics › Hemoglobinopathies and Related Disorders
- Keywords
- malaria in pregnancy, neonatal malaria, perinatal mortality, low birth weight, chloroquine prophylaxis, Plasmodium falciparum, maternal malaria, placental malaria, malaria chemoprophylaxis, chloroquine resistance
- MeSH terms
- Birth Weight, Chloroquine, Drug Resistance, Female, Fetal Death, Humans, Infant, Newborn, Pregnancy, Pregnancy Complications, Parasitic, Malaria, Falciparum
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
