CAUSES OF PRETERM DELIVERY AND INTRAUTERINE GROWTH-RETARDATION IN A MALARIA ENDEMIC REGION OF PAPUA-NEW-GUINEA

Aim-To identify causes of preterm delivery and intrauterine growth ret ardation (IUGR) in a malaria endemic region of Papua New Guinea. Metho ds-Independent predictors of preterm delivery and birthweight in term infants were identified using multiple regression analysis in a prospe ctive study of 987 singleton live births delivered in Madang Hospital. Results-Overall, Plasmodium falciparum infection of the placenta was associated with a reduction in birthweight of 130 g. Malaria was signi ficantly more common in primigravidae than multigravidae and probably contributed to both preterm delivery and IUGR. Maternal haemoglobin co ncentrations were significantly lower in malaria infected than noninfe cted women and reduced haemoglobin was the main determinant of preterm delivery. Poorer maternal nutritional status and smoking were associa ted with both prematurity and IUGR. Greater antenatal clinic attendanc e predicted increased birthweight in term infants. Conclusions-Protect ion against malaria during pregnancy, especially in primigravidae, imp roved nutrition in women and discouragement of smoking would probably reduce both preterm delivery and IUGR. Greater use of existing antenat al clinics might increase birthweight in term infants.