Plasmodium falciparum isolates from infected pregnant women and children are associated with distinct adhesive and antigenic properties

Plasmodium falciparum malaria during pregnancy is an important cause of mat ernal and infant morbidity and mortality. Accumulation of large numbers of P. falciparum-infected erythrocytes in the maternal blood spaces of the pla centa may be mediated by adhesion of infected erythrocytes to molecules pre sented on the syncytiotrophoblast surface, In this study, isolates from pla centas and peripheral blood of infected pregnant women and from children we re tested for binding to purified receptors and for agglutination with adul t sera. Results suggest that adhesion to chondroitin sulfate A may be invol ved in placental parasite sequestration in most cases, but other factors ar e also likely to be important, Agglutination assay results suggest that par asites infecting pregnant women are antigenically distinct from those commo n in childhood disease. The prevalence of agglutinating antibodies to pregn ancy isolates was generally low, but it was highest in multigravidae who ar e likely to have had the greatest exposure.