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

Malaria Journal

Research

Hilton Whittle¹  Katie L Flanagan¹  Ebrima Touray¹  Brigitte Walther¹  Melba S Palmero²  Olubukola Ojuola³  Marianne van der Sande⁴  Pauline Waight⁵  Sarah Crozier⁶  Sarah Rowland-Jones⁷  David JC Miles⁸ 

[1] MRC Laboratories, Atlantic Boulevard, PO Box 273, Banjul, Fajara, The Gambia;MRC Laboratories, Atlantic Boulevard, PO Box 273, Banjul, Fajara, The Gambia;Adventist Community Services of Alaska, 6100 O'Malley Road, Anchorage, USA;MRC Laboratories, Atlantic Boulevard, PO Box 273, Banjul, Fajara, The Gambia;Department of Pediatrics, Bronx-Lebanon Hospital Center, 1650 Grand Concourse, New York, Bronx, USA;MRC Laboratories, Atlantic Boulevard, PO Box 273, Banjul, Fajara, The Gambia;Epidemiology and Surveillance Unit, Centre for Infectious Diseases Control, National Institute for Public Health and the Environment, Bilthoven, Netherlands;MRC Laboratories, Atlantic Boulevard, PO Box 273, Banjul, Fajara, The Gambia;Immunization Department, Health Protection Agency Centre for Infections, Colindale Avenue, London, UK;MRC Laboratories, Atlantic Boulevard, PO Box 273, Banjul, Fajara, The Gambia;MRC Epidemiology Resource Centre, University of Southampton, Southampton General Hospital, Southampton, UK;MRC Laboratories, Atlantic Boulevard, PO Box 273, Banjul, Fajara, The Gambia;MRC Human Immunology Unit, Weatherall Institute of Molecular Medicine, John Radcliffe Hospital, Oxford, UK;MRC Laboratories, Atlantic Boulevard, PO Box 273, Banjul, Fajara, The Gambia;South African Tuberculosis Vaccine Initiative, Institute of Infectious Diseases and Molecular Medicine, and School of Child and Adolescent Health, University of Cape Town, Observatory, South Africa;

关键词: Malaria;    Malaria Transmission;    Generalize Estimate Equation;    Univariable Analysis;    Placental Malaria;   

DOI  :  10.1186/1475-2875-9-16

 received in 2009-09-11, accepted in 2010-01-14,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundInfection 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.MethodsIn 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.ResultsIndependent 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.ConclusionsIt 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.

【 授权许可】

CC BY   
© Walther et al; licensee BioMed Central Ltd. 2010