Microscopic and sub-microscopic Plasmodium falciparum infection, but not inflammation caused by infection, is associated with low birth weight

被引:81
|
作者
Adegnika, Ayola A.
Verweij, Jaco J.
Agnandji, Selidji T.
Chai, Sanders K.
Breitling, Lutz Ph.
Ramharter, Michael
Frolich, Marijke
Issifou, Saadou
Kremsner, Peter G.
Yazdanbakhsh, Maria
机构
[1] Leiden Univ, Med Ctr, Dept Parasitol, NL-2333 ZA Leiden, Netherlands
[2] Albert Schweitzer Hosp, Med Res Unit, Lambarene, Gabon
[3] Univ Tubingen, Dept Parasitol, Inst Trop Med, Tubingen, Germany
[4] Leiden Univ, Med Ctr, Dept Clin Chem, Leiden, Netherlands
来源
关键词
D O I
10.4269/ajtmh.2006.75.798
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Pregnancy-associated malaria is one of the leading causes of low birth weight in malaria endemic areas. In this study, 145 parturient women residing in areas endemic for Plasmodium falciparum in Lambarene, Gabon, were recruited into the study after delivery, and the association of maternal P. falciparum infection, inflammatory response, and birth weight was studied. At delivery, 10% (15) of the mothers (12 were positive in both peripheral and placental blood smears, 1 was positive in peripheral blood only, and 2 were positive in placenta blood only) were positive for P. falciparum by microscopy and 23% (30) by real-time polymerase chain reaction (PCR). The level of C-reactive protein (CRP) was significantly elevated in microscopically P. falciparum-positive pregnant women (34 mg/L; 95% CI: 3-458) but not in those with sub-microscopic infections (6 mg/L; 95% CI: 1-40) compared with those free of P. falciparum infection (7 mg/L; 95% CI: 1-43). In a multivariate analysis, the presence of microscopic (adjusted OR = 28.6, 95% CI = 4.8-169.0) or sub-microscopic (adjusted OR = 13.2, 95% CI = 2.4-73.0) P. falciparum infection in pregnant women and age of mothers < 21 years (adjusted OR = 9.7 CI = 1.0-89.7), but not CRP levels, were independent predictors for low birth weight. This finding may have important operational implications and emphasizes the need for appropriate diagnostic methods in studies evaluating the outcome of pregnancy-associated malaria.
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页码:798 / 803
页数:6
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