Plasmodium falciparum infection early in pregnancy has profound consequences for fetal growth

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Christentze Schmiegelow, Sungwa Matondo, Daniel T R Minja, Mafalda Resende, Caroline Pehrson, Birgitte Bruun Nielsen, Raimos Olomi, Morten A Nielsen, Philippe Deloron, Ali Salanti, John Lusingu, Thor G Theander

Malaria during pregnancy constitutes a large health problem in areas of endemicity. The World Health Organization recommends that interventions are initiated at the first antenatal visit, and these improve pregnancy outcomes. This study evaluated fetal growth by ultrasonography and birth outcomes in women who were infected prior to the first antenatal visit (gestational age, <120 days) and not later in pregnancy. Compared with uninfected controls, women with early Plasmodium falciparum exposure had retarded intrauterine growth between gestational ages of 212 and 253 days (difference between means, 107 g [95% confidence interval {CI}, 26-188]; P = .0099) and a shorter pregnancy duration (difference between means, 6.6 days [95% CI, 1.0-112.5]; P = .0087). The birth weight (difference between means, 221 g [95% CI, 6-436]; P = .044) and the placental weight (difference between means, 84 g [95% CI, 18-150]; P = .013) at term were also reduced. The study suggests that early exposure to P. falciparum, which is not targeted for prevention by current control strategies, has a profound impact on fetal growth, pregnancy duration, and placental weight at term.

Original languageEnglish
JournalThe Journal of Infectious Diseases
Volume216
Issue number12
Pages (from-to)1601-1610
Number of pages10
ISSN0022-1899
DOIs
Publication statusPublished - 19 Dec 2017

    Research areas

  • Journal Article

ID: 187289802