Placental Histopathologic Changes Associated with Subclinical Malaria Infection and Its Impact on the Fetal Environment
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Microscopic examination of placental tissue can provide an accurate assessment of malaria infection during pregnancy. In this cross-sectional study of 193 women in Iquitos, Peru, 1.0% and 6.6% had parasites in the peripheral blood as detected by microscopy and polymerase chain reaction, respectively. However, 22% had placental malaria pigment indicating past, subclinical infections. Placental tissues with pigment from 24 cases were matched by gravidity and month of delivery to 24 controls and histopathologically examined. Cases had significantly higher number of monocytes in the intervillous space (44.7 versus 25.5; P = 0.012). Pigmented monocytes in fetal vessels were present in 33.3% of cases. This study demonstrated that subclinical malarial infection occurred frequently in pregnant women and is associated with increased presence of monocytes in the placenta. Pigmented monocytes in fetal vessels suggest parasites can breach the placental barrier and enter the fetal circulation.
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Cytokine responses such as Th1, Th2, interleukins, TNF and regulators, IFN gamma, and monocytes have been observed in pregnant women with malaria.
“Besides the antibody responses to VSAPAM, cytokine responses such as Th1, Th2, interleukins, TNF and regulators, IFN gamma,70–72 and monocytes73 have been observed in pregnant women with malaria.”
From Malaria in pregnancy. (2013) · cites this paper as [73]
A 2-parameter grading system distinguishing between inflammation and pigment deposition has been proposed as it correlates with pregnancy outcomes in Tanzania and Thailand.
“Recently, a 2-parameter grading system, distinguishing between inflammation and pigment deposition, has been proposed as it correlates with pregnancy outcomes, in both a stable transmission setting in Tanzania, and an unstable setting in Thailand.73”
From Malaria in pregnancy. (2013) · cites this paper as [73]
Malaria-associated placental changes have been described for stable and unstable transmission settings.
“Malaria-associated placental changes have been described for stable72,80 and unstable transmission settings.73,81”
From Malaria in pregnancy. (2013) · cites this paper as [73]
In studies from Brazil, Bolivia, Peru, and Venezuela, P. vivax was associated with anemia, reduced birth weight, and histological changes in the placenta.
“In studies from Brazil, Bolivia, Peru, and Venezuela, P. vivax was associated with anemia, reduced birth weight, and histological changes in the placenta (12)(13)(14)(15).”
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 [12]
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References 33 · Cited by 49
- Authors
- Parekh, F. K., Davison, B. B., Gamboa, D., Hernandez, J., & Branch, O. H.
- Affiliations
- Tulane University (US)
- Corresponding author
- Branch, OraLee H.
- Venue
- The American Society of Tropical Medicine and Hygiene
- Published
- 2010-11-05
- Volume
- 83
- Issue
- 5
- Pages
- 973-980
- ISSN
- 0002-9637 (ISSN-L)
- 1476-1645
- PMC
- PMC2963955
- OpenAlex
- W2115489900
- Cited by
- 49
- References
- 33
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 7 · 2023: 3 · 2022: 3 · 2021: 6 · 2020: 1 · 2019: 3 · 2018: 3 · 2017: 4 · 2016: 3 · 2015: 3 · 2014: 1 · 2013: 6 · 2012: 4
- FWCI
- 3.18
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Tropical Medicine and Hygiene (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Public Health Service (UR3/CCU418652, R01AL064831)
- National Institute of Allergy and Infectious Diseases (R01AI064831)
- Fogarty International Center (R03TW008064)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Malaria Research and Control
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Life Sciences › Immunology and Microbiology › Immunology › Reproductive System and Pregnancy
- Keywords
- placental malaria, malaria in pregnancy, placental pathology, monocytes, intervillous space, fetal vessels, placental barrier, intrauterine environment, Plasmodium falciparum
- MeSH terms
- Adolescent, Adult, Cross-Sectional Studies, Female, Hemeproteins, Humans, Monocytes, Peru, Pigments, Biological, Placenta, Pregnancy, Pregnancy Complications, Parasitic, Case-Control Studies, Malaria, Falciparum, Malaria, Vivax, Parasitemia, Young Adult
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