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Malaria Journal
Published in: Malaria Journal 1/2010

Open Access 01-12-2010 | Research

Placental Malaria is associated with reduced early life weight development of affected children independent of low birth weight

Authors: Brigitte Walther, David JC Miles, Sarah Crozier, Pauline Waight, Melba S Palmero, Olubukola Ojuola, Ebrima Touray, Marianne van der Sande, Hilton Whittle, Sarah Rowland-Jones, Katie L Flanagan

Published in: Malaria Journal | Issue 1/2010

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Abstract

Background

Infection with Plasmodium falciparum during pregnancy contributes substantially to the disease burden in both mothers and offspring. Placental malaria may lead to intrauterine growth restriction or preterm delivery resulting in low birth weight (LBW), which, in general, is associated with increased infant morbidity and mortality. However, little is known about the possible direct impact of the specific disease processes occurring in PM on longer term outcomes such as subsequent retarded growth development independent of LBW.

Methods

In an existing West-African cohort, 783 healthy infants with a birth weight of at least 2,000 g were followed up during their first year of life. The aim of the study was to investigate if Plasmodium falciparum infection of the placenta, assessed by placental histology, has an impact on several anthropometric parameters, measured at birth and after three, six and 12 months using generalized estimating equations models adjusting for moderate low birth weight.

Results

Independent of LBW, first to third born infants who were exposed to either past, chronic or acute placental malaria during pregnancy had significantly lower weight-for-age (-0.43, 95% CI: -0.80;-0.07), weight-for-length (-0.47, 95% CI: -0.84; -0.10) and BMI-for-age z-scores (-0.57, 95% CI: -0.84; -0.10) compared to infants born to mothers who were not diagnosed with placental malaria (p = 0.019, 0.013, and 0.012, respectively). Interestingly, the longitudinal data on histology-based diagnosis of PM also document a sharp decline of PM prevalence in the Sukuta cohort from 16.5% in 2002 to 5.4% in 2004.

Conclusions

It was demonstrated that PM has a negative impact on the infant's subsequent weight development that is independent of LBW, suggesting that the longer term effects of PM have been underestimated, even in areas where malaria transmission is declining.
Appendix
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Metadata
Title
Placental Malaria is associated with reduced early life weight development of affected children independent of low birth weight
Authors
Brigitte Walther
David JC Miles
Sarah Crozier
Pauline Waight
Melba S Palmero
Olubukola Ojuola
Ebrima Touray
Marianne van der Sande
Hilton Whittle
Sarah Rowland-Jones
Katie L Flanagan
Publication date
01-12-2010
Publisher
BioMed Central
Published in
Malaria Journal / Issue 1/2010
Electronic ISSN: 1475-2875
DOI
https://doi.org/10.1186/1475-2875-9-16

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