Malaria infection during pregnancy: Intrauterine growth retardation and preterm delivery in Malawi

In sub-Saharan Africa, malaria infection in pregnancy contributes to low bi rth weight through intrauterine growth retardation (IUGR) and preterm deliv ery (PTD), It was hypothesized that malaria-associated PTD and IUGR have di ffering etiologies due to timing of infection, In a prospective cohort of p rimigravid women enrolled at the antenatal clinic of Mangochi District Hosp ital in Malawi, the associations were investigated between antenatal or del ivery parasitemias and IUGR or PTD, Among 178 singleton deliveries, 35% of infants were preterm or had IUGR, Cord blood parasitemia (odds ratio [OR] = 3.34; 95% confidence interval [CI], 1.3-8.8], placental parasitemia (OR = 2.43; 95% CI, 1.2-5.1), and postdelivery maternal peripheral parasitemia (O R = 2.78; 95% CI, 1.3-6.1) were associated with PTD, Parasitemia and/or cli nically diagnosed malaria in the antenatal period was associated with IUGR (OR = 5.13; 95% CI, 1.4-19.4). Delivery parasitemias had borderline associa tions with IUGR, The risk patterns observed suggest that the timing and sev erity of infection influences the occurrence of IUGR or PTD.