In utero exposure to malaria is associated with metabolic traits in adolescence: The Agogo 2000 birth cohort study

Objectives: Malaria in pregnancy (MiP) contributes to fetal undernutrition and adverse birth outcomes, and may constitute a developmental origin of metabolic diseases in the offspring. In a Ghanaian birth cohort, we examined the relationships between MiP-exposure and metabolic traits in adolescence. Methods: MiP at delivery was assessed in 155 mother-child pairs. Among the now teenaged children (mean age, 14.8 years; 53% male), we measured fasting plasma glucose (FPG), body mass index (BMI), and systolic and diastolic blood pressure (BP). Associations of MiP with the adolescents' FPG, BMI, and BP were examined by linear regression. Results: At delivery, 45% were MiP-exposed, which increased FPG in adolescence, adjusted for mother's age at delivery, parity and familial socio-economic status (infected vs. uninfected: mean Delta FPG = 0.20 mmol/L; 95% confidence interval (CI): 0.01, 0.39; p = 0.049). As a trend, this was discernible for BP, particularly for microscopic infections (mean Delta systolic BP = 5.43 mmHg; 95% CI: 0.00, 10.88; p = 0.050; mean.diastolic BP = 3.67 mmHg; 95% CI: -0.81, 8.14; p = 0.107). These associations were largely independent of birth weight, gestational age and teenage BMI. Adolescent BMI was not related to MiP. Conclusions: In rural Ghana, exposure to malaria during fetal development contributes to metabolic conditions in young adulthood. (C) 2017 The Authors. Published by Elsevier Ltd on behalf of The British Infection Association.