Risk factors for fetal anaemia in a malarious area of Malawi
Abstract
The prevalence of infants born with low cord haemoglobin (fetal anaemia) is high in areas where malaria and iron deficiency anaemia in pregnancy are common. The objective of the present study was to determine risk factors for fetal anaemia in an area of high malaria transmission in southern Malawi. A case control study was undertaken with fetal anaemia defined as cord haemoglobin (Hb) < 12.5 g/dl. Between March 1993 and July 1994, pregnant women attending the study hospitals for the first time in that pregnancy were enrolled. Data on socio-economic status, anthropometry, previous obstetric history and current pregnancy were collected. Malaria parasitaemia, Hb levels and iron status were measured in maternal blood at recruitment and delivery and in umbilical venous blood. Fetal anaemia occurred in 23.4% of babies. Mean (SD) cord Hb was 13.6 g/dl (1.83). Factors associated with fetal anaemia were: birth in the rainy season [adjusted odds ratio (AOR) 2.33, 95% CI 1.73-3.14], pre-term delivery (AOR 1.60, 1.03-2.49), infant Hb < 14 g/dl at 24 hours (AOR 2.35, 1.20-4.59), maternal Hb at delivery < 8 g/dl (AOR 1.61, 1.10-2.42) or <11 g/dl (AOR 1.60, 1.10-2.31). A higher prevalence of fetal anaemia occurred with increasing peripheral Plasmodium falciparum parasite density (p=0.03) and geometric mean placental parasite densities were higher in babies with fetal anaemia than in those without (3331 vs 2152 parasites/microl, p=0.07). Interventions should aim to reduce fetal anaemia by im…
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The central phenomenon mediating the pathogenesis of PAM is the accumulation of infected erythrocytes in the placenta.
“It is now clear that the central phenomenon mediating the pathogenesis of PAM is the accumulation of infected erythrocytes (iE) in the placenta (Brabin et al. , 2004).”
From Towards a vaccine against pregnancy-associated malaria (2008) · cites this paper as Brabin et al., 2004
Placental malaria is associated with a two-fold increased risk of low birthweight (<2500 g), with the greatest effect in primigravidae.
“placental malaria is associated with a two-fold increased risk to give birth to a LBW baby, with the greatest effect in primigravidae (Brabin et al. , 2004).”
From Towards a vaccine against pregnancy-associated malaria (2008) · cites this paper as Brabin et al., 2004
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References 40 · Cited by 67
- Authors
- Brabin, B. J., Kalanda, B. F., Verhoeff, F. H., Chimsuku, L. H., & Broadhead, R. L.
- Affiliations
- Liverpool School of Tropical Medicine (GB)
- University of Malawi (MW)
- Venue
- Annals of Tropical Paediatrics
- Publisher
- Informa UK Limited
- Published
- 2004-12
- Volume
- 24
- Issue
- 4
- Pages
- 311-321
- ISSN
- 0272-4936 (ISSN-L)
- 1465-3281
- OpenAlex
- W2087510433
- Cited by
- 67
- References
- 40
- Citations by year
- 2025: 3 · 2024: 1 · 2023: 4 · 2022: 2 · 2021: 3 · 2020: 3 · 2019: 1 · 2018: 2 · 2016: 3 · 2015: 2 · 2014: 3 · 2013: 6 · 2012: 3
- FWCI
- 7.47
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Annals of Tropical Paediatrics (publishedVersion)
- PubMed (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Funders
- European Commission
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Malaria Research and Control
- Health Sciences › Medicine › Hematology › Iron Metabolism and Disorders
- Health Sciences › Medicine › Genetics › Hemoglobinopathies and Related Disorders
- Keywords
- fetal anemia, malaria in pregnancy, Plasmodium falciparum, preterm birth, maternal hemoglobin, umbilical venous blood, risk factors, Malawi
- MeSH terms
- Adult, Anemia, Neonatal, Female, Fetal Blood, Fetal Diseases, Hemoglobins, Humans, Infant, Newborn, Malaria, Malawi, Placenta, Pregnancy, Pregnancy Trimesters, Risk Factors, Seasons, Prevalence, Case-Control Studies, Endemic Diseases, Gravidity
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