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Cited by 113Malaria Research and ControlPregnancy and preeclampsia studiesGlobal Maternal and Child Health

MICROSCOPIC AND SUB-MICROSCOPIC PLASMODIUM FALCIPARUM INFECTION, BUT NOT INFLAMMATION CAUSED BY INFECTION, IS ASSOCIATED WITH LOW BIRTH WEIGHT

ADEGNIKA, AYÔLA A., VERWEIJ, JACO J., AGNANDJI, SELIDJI T., CHAI, SANDERS K., BREITLING, LUTZ PH., RAMHARTER, MICHAEL, FROLICH, MARIJKE, ISSIFOU, SAADOU +2 more·2006·The American Journal of Tropical Medicine and Hygiene
DOI 10.4269/ajtmh.2006.75.798
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Abstract

Pregnancy-associated malaria is one of the leading causes of low birth weight in malaria endemic areas. In this study, 145 parturient women residing in areas endemic for Plasmodium falciparum in Lambaréné, Gabon, were recruited into the study after delivery, and the association of maternal P. falciparum infection, inflammatory response, and birth weight was studied. At delivery, 10% (15) of the mothers (12 were positive in both peripheral and placental blood smears, 1 was positive in peripheral blood only, and 2 were positive in placenta blood only) were positive for P. falciparum by microscopy and 23% (30) by real-time polymerase chain reaction (PCR). The level of C-reactive protein (CRP) was significantly elevated in microscopically P. falciparum–positive pregnant women (34 mg/L; 95% CI: 3–458) but not in those with sub-microscopic infections (6 mg/L; 95% CI: 1–40) compared with those free of P. falciparum infection (7 mg/L; 95% CI: 1–43). In a multivariate analysis, the presence of microscopic (adjusted OR = 28.6, 95% CI = 4.8–169.0) or sub-microscopic (adjusted OR = 13.2, 95% CI = 2.4–73.0) P. falciparum infection in pregnant women and age of mothers < 21 years (adjusted OR = 9.7 CI = 1.0–89.7), but not CRP levels, were independent predictors for low birth weight. This finding may have important operational implications and emphasizes the need for appropriate diagnostic methods in studies evaluating the outcome of pregnancy-associated malaria.

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  • SMIs are frequently detected in pregnant women in sub-Saharan Africa and were associated with adverse outcomes in several cross-sectional and longitudinal studies.

    “SMIs are also frequently detected in pregnant women in sub-Saharan Africa and were associated with adverse outcomes in several cross-sectional (21)(22)(23)(24) and longitudinal studies (25,26).”

    From Clinical outcomes of submicroscopic infections and correlates of protection of VAR2CSA antibodies in a longitudinal study of pregnant women in Colombia (2018) · cites this paper as [21]

  • Two studies reported that pregnancy malaria detected by blood smear microscopy or by PCR only (submicroscopic infection) was associated with increased low birthweight deliveries.

    “Two studies reported that PM detected by either BS microscopy or by PCR only (submicroscopic infection) was associated with increased LBW deliveries [44,45].”

    From Diagnosing malaria in pregnancy: An update (2012) · cites this paper as [44]

  • Submicroscopic placental infection was associated with reduced birthweight in several studies.

    “Submicroscopic placental infection was associated with reduced birthweight in several studies [15,44,45].”

    From Diagnosing malaria in pregnancy: An update (2012) · cites this paper as [44]

  • Data are conflicting about the impact of submicroscopic infections on LBW; some studies suggest increased risk and others no association.

    “Similarly, the data are conflicting about the impact of submicroscopic infections on LBW; some studies suggest an increased risk 16,24 in the setting of submicroscopic infections and others no association. 20-23”

    From What is the burden of submicroscopic malaria in pregnancy in central India? (2015) · cites this paper as [16]

  • Studies in Africa have consistently shown that conventional microscopy vastly underestimates infection compared to PCR in both peripheral and placental blood samples.

    “These studies have consistently shown that conventional microscopy vastly underestimates infection compared to PCR in both peripheral and placental blood samples. 12-22”

    From What is the burden of submicroscopic malaria in pregnancy in central India? (2015) · cites this paper as [16]

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Authors
ADEGNIKA, A. A., VERWEIJ, J. J., AGNANDJI, S. T., CHAI, S. K., BREITLING, L. P., RAMHARTER, M., FROLICH, M., ISSIFOU, S., KREMSNER, P. G., & YAZDANBAKHSH, M.
Affiliations
  • Medical Research Unit, Albert Schweitzer Hospital, Lambaréné, Gabon; Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands; Department of Parasitology, Institute of Tropical Medicine, University of Tübingen, Tübingen Germany; Department of Clinical Chemistry, Leiden University Medical Center, Leiden, The Netherlands
  • Albert Schweitzer Hospital (GA)
ORCID
Venue
The American Journal of Tropical Medicine and Hygiene
Publisher
American Society of Tropical Medicine and Hygiene
Published
2006-11
Volume
75
Issue
5
Pages
798-803
ISSN
0002-9637 (ISSN-L)
DOI
10.4269/ajtmh.2006.75.798
OpenAlex
W2165066248
Cited by
113
References
52
Citations by year
2025: 1 · 2024: 2 · 2023: 8 · 2021: 5 · 2020: 11 · 2019: 6 · 2018: 6 · 2017: 3 · 2016: 4 · 2015: 8 · 2014: 13 · 2013: 8 · 2012: 13
FWCI
4.00
Type
journal article
Language
en
Open access
closed
Locations
  • American Journal of Tropical Medicine and Hygiene (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Malaria Research and Control
  • Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
Keywords
Plasmodium falciparum, malaria in pregnancy, low birth weight, C-reactive protein, maternal inflammation, placental malaria, parturients, malaria diagnosis, maternal age
MeSH terms
Adolescent, Adult, Animals, Female, Humans, Infant, Low Birth Weight, Infant, Newborn, Placenta Diseases, Plasmodium falciparum, Pregnancy, Pregnancy Complications, Parasitic, DNA, Protozoan, Polymerase Chain Reaction, Malaria, Falciparum

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