S. Meuris et al., GESTATIONAL MALARIA - ASSESSMENT OF ITS CONSEQUENCES ON FETAL GROWTH, The American journal of tropical medicine and hygiene, 48(5), 1993, pp. 603-609
Citations number
39
Categorie Soggetti
Public, Environmental & Occupation Heath","Tropical Medicine
In a region of Africa (Nord-Kivu, Zaire) where malaria is endemic, cir
culating malaria parasites, malaria-associated placental lesions, and
a low hemoglobin level (< 10 g/dl) were observed, either singly or in
combination, in 73.1% of women (n = 461) delivering at the maternity h
ospital. These pathologic findings were associated with low birthweigh
t in 18.1% of the newborns, whereas the prevalence of low birthweight
was 6.4% among cases without these findings (P < 0.05). Parasitemia wa
s observed in 17.4% of all mothers and was associated with a significa
nt decrease in birthweight. Malaria-associated lesions were found in 5
2.5% of all placentas and were associated with a decrease in birthweig
ht, head circumference, and ponderal index of the newborns. Such lesio
ns were more frequently observed among primiparae (60.5%) than among m
ultiparae (49.5%; P < 0.05). Lastly, a low hemoglobin level, found in
38.6% of the mothers, was associated with a decrease in birthweight, l
ength, and head circumference. The differences in the physical effects
associated with each of the pathologic conditions suggest that parasi
temia, placental lesions, and anemia result in acute, subacute, and ch
ronic impairment of fetal growth, respectively. Moreover, their delete
rious effects may be cumulative, since the most dramatically affected
physical patterns were found when the pathologic findings were associa
ted in the same patient. Frequent antenatal monitoring of maternal hem
oglobin and parasitemia, accompanied, when necessary, with curative tr
eatments, may help to reduce the prevalence of intrauterine growth ret
ardation and its procession of perinatal complications.