Falciparum but not vivax malaria increases the risk of hypertensive disorders of pregnancy in women followed prospectively from the first trimester

BMC Medicine

Nicholas J. White¹  Kesinee Chotivanich²  Kerryn A. Moore³  Stephane Proux⁴  Aung Myat Min⁴  Moo Kho Paw⁴  Nay Win Tun⁴  Mary Ellen Gilder⁴  Jacher Wiladphaingern⁴  Rose McGready⁵  François Nosten⁵  Whitney E. Harrington⁶  Marcus J. Rijken⁷ 

[1] Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Oxford, UK;Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand;Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand;London School of Hygiene and Tropical Medicine, London, UK;Murdoch Children’s Research Institute, Melbourne, Australia;Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand;Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand;Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Oxford, UK;Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand;Department of Pediatrics, University of Washington, Seattle, WA, USA;Seattle Children’s Research Institute, Seattle, WA, USA;Utrecht University Medical Centre, Utrecht, the Netherlands;Julius Centre Global Health, Utrecht, the Netherlands;

关键词: First trimester;    Falciparum malaria;    Pre-eclampsia;    Gestational hypertension;    Vivax malaria;   

DOI  :  10.1186/s12916-021-01960-3

来源: Springer

【 摘 要 】

BackgroundMalaria and hypertensive disorders of pregnancy (HDoP) affect millions of pregnancies worldwide, particularly those of young, first-time mothers. Small case-control studies suggest a positive association between falciparum malaria and risk of pre-eclampsia but large prospective analyses are lacking.MethodsWe characterized the relationship between malaria in pregnancy and the development of HDoP in a large, prospectively followed cohort. Pregnant women living along the Thailand-Myanmar border, an area of low seasonal malaria transmission, were followed at antenatal clinics between 1986 and 2016. The relationships between falciparum and vivax malaria during pregnancy and the odds of gestational hypertension, pre-eclampsia, or eclampsia were examined using logistic regression amongst all women and then stratified by gravidity.ResultsThere were 23,262 singleton pregnancies in women who presented during the first trimester and were followed fortnightly. Falciparum malaria was associated with gestational hypertension amongst multigravidae (adjusted odds ratio (AOR) 2.59, 95%CI 1.59–4.23), whereas amongst primigravidae, it was associated with the combined outcome of pre-eclampsia/eclampsia (AOR 2.61, 95%CI 1.01–6.79). In contrast, there was no association between vivax malaria and HDoP.ConclusionsFalciparum but not vivax malaria during pregnancy is associated with hypertensive disorders of pregnancy.

【 授权许可】

CC BY