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A cohort study of Plasmodium falciparum malaria in pregnancy and associations with uteroplacental blood flow and fetal anthropometrics in Kenya
Author(s) -
McClure Elizabeth M.,
Meshnick Steven R.,
Lazebnik Noam,
Mungai Peter,
King Christopher L.,
Hudgens Michael,
Goldenberg Robert L.,
SiegaRiz AnnaMaria,
Dent Arlene E.
Publication year - 2014
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2014.01.016
Subject(s) - medicine , malaria , pregnancy , obstetrics , anthropometry , cohort , low birth weight , plasmodium falciparum , birth weight , sulfadoxine , body mass index , immunology , pyrimethamine , biology , genetics
Objective To use ultrasound to explore the impact of malaria in pregnancy on fetal growth and newborn outcomes among a cohort of women enrolled in an intermittent presumptive treatment in pregnancy (IPTp) with sulfadoxine/pyrimethamine (SP) program in coastal Kenya. Methods Enrolled women were tested for malaria at first prenatal care visit, and physical and ultrasound examinations were performed. In total, 477 women who had term, live births had malaria tested at delivery and their birth outcomes assessed, and were included in the study. Results Peripheral malaria was detected via polymerase chain reaction among 10.9% (n = 87) at first prenatal care visit and 8.8% (n = 36) at delivery. Insecticide‐treated bed nets (ITNs) were used by 73.6% (n = 583) and were associated with decreased malaria risk. There was a trend for impaired fetal growth and placental blood flow in malaria‐infected women in the second trimester, but not later in pregnancy. Among women with low body mass index (BMI), malaria was associated with reduced birth weight ( P = 0.04); anthropometric measures were similar otherwise. Conclusion With IPTp‐SP and ITNs, malaria in pregnancy was associated with transient differences in utero, and reduced birth weight was restricted to those with low BMI.