Causes of preterm delivery and intrauterine growth retardation in a malaria endemic region of Papua New Guinea.
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AIM To identify causes of preterm delivery and intrauterine growth retardation (IUGR) in a malaria endemic region of Papua New Guinea. METHODS Independent predictors of preterm delivery and birthweight in term infants were identified using multiple regression analysis in a prospective study of 987 singleton live births delivered in Madang Hospital. RESULTS Overall, Plasmodium falciparum infection of the placenta was associated with a reduction in birthweight of 130 g. Malaria was significantly more common in primigravidae than multigravidae and probably contributed to both preterm delivery and IUGR. Maternal haemoglobin concentrations were significantly lower in malaria infected than non-infected women and reduced haemoglobin was the main determinant of preterm delivery. Poorer maternal nutritional status and smoking were associated with both prematurity and IUGR. Greater antenatal clinic attendance predicted increased birthweight in term infants. CONCLUSIONS Protection against malaria during pregnancy, especially in primigravidae, improved nutrition in women and discouragement of smoking would probably reduce both preterm delivery and IUGR. Greater use of existing antenatal clinics might increase birthweight in term infants. Key points In coastal Papua New Guinea, roughly a third of low birthweight infants were preterm and two thirds were growth retarded, term infants Protection from malaria during pregnancy, especially in primigravidae, may prevent both IUGR and preterm delivery A reduced maternal haemoglobin concentration was the main determinant of preterm birth Prevention of smoking during pregnancy, improved nutrition in girls and women, and increased antenatal care may also prevent low birthweight in this region
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P. vivax infection during pregnancy is associated with stillbirth, preterm delivery, low birthweight, and anaemia.
“Plasmodium vivax is also associated with stillbirth [1], preterm delivery [14], low birthweight [15, 16], and anaemia [16–18]”
From Global estimates of pregnancies at risk of Plasmodium falciparum and Plasmodium vivax infection in 2020 and changes in risk patterns since 2000 (2022) · cites this paper as [14]
Malaria in pregnancy due to P. falciparum and P. vivax is common in coastal Papua New Guinea, and its greatest impact on birth weight is in primigravid women.
“Malaria in pregnancy due to P. falciparum and P. vivax is common, 6 and its greatest impact on birth weight is in primigravid women.[6][7][8]”
The prevalence of preterm delivery was 21.7%, whereas it was estimated at 6-10% in other studies, probably due to differences in sensitivity of dating techniques used.
“The prevalence of preterm delivery was 21.7%, whereas it was estimated at 6-10% in other studies, 6,7 probably due to differences in sensitivity of dating techniques used.”
Previous studies performed in the region showed a similar prevalence of malaria infection, low birth weight and anaemia.
“Previous studies performed in the region showed a similar prevalence of malaria infection, LBW and anaemia.6,7”
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Malaria in pregnancy in the Asia-Pacific region
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- Authors
- Allen, S. J., Raiko, A., O’Donnell, A., Alexander, N. D. E., & Clegg, J. B.
- Affiliations
- John Radcliffe Hospital (GB)
- Corresponding author
- Allen, S J
- Venue
- Archives of Disease in Childhood - Fetal and Neonatal Edition
- Publisher
- BMJ
- Published
- 1998-09-01
- Volume
- 79
- Issue
- 2
- Pages
- F135-F140
- ISSN
- 1359-2998 (ISSN-L)
- 1468-2052
- PMC
- PMC1720830
- OpenAlex
- W2137490291
- Cited by
- 49
- References
- 34
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 2 · 2022: 1 · 2018: 1 · 2017: 2 · 2016: 2 · 2015: 6 · 2014: 3 · 2013: 1 · 2012: 2
- FWCI
- 0.43
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Archives of Disease in Childhood Fetal & Neonatal (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Wellcome Trust
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Malaria Research and Control
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and Neonatal Healthcare
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
- Keywords
- preterm birth, fetal growth restriction, low birth weight, malaria in pregnancy, Plasmodium falciparum, placental malaria, primigravida, maternal hemoglobin, maternal nutritional status, maternal smoking, prenatal care, antenatal care attendance, Papua New Guinea
- MeSH terms
- Adult, Female, Fetal Growth Retardation, Hemoglobins, Humans, Infant, Newborn, Obstetric Labor, Premature, Nutrition Disorders, Papua New Guinea, Parity, Patient Acceptance of Health Care, Placenta, Pregnancy, Prenatal Care, Smoking, Pregnancy Complications, Parasitic, Malaria, Falciparum
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