Dataset Information

Association of Malaria Infection During Pregnancy With Head Circumference of Newborns in the Brazilian Amazon.

ABSTRACT:

Importance

Malaria during pregnancy is associated with adverse events for the fetus and newborn, but the association of malaria during pregnancy with the head circumference of the newborn is unclear.

Objective

To investigate the association of malaria during pregnancy with fetal head growth.

Design, setting, and participants

Two cohort studies were conducted at the general maternity hospital of Cruzeiro do Sul (Acre, Brazil) in the Amazonian region. One cohort study prospectively enrolled noninfected and malaria-infected pregnant women who were followed up until delivery, between January 2013 and April 2015. The other cohort study was assembled retrospectively using clinical and malaria data from all deliveries that occurred between January 2012 and December 2013. Data analyses were conducted from January to August 2017 and revised in November 2018. Clinical data from pregnant women and anthropometric measures of their newborns were evaluated. A total of 600 pregnant women were enrolled through volunteer sampling (prospective cohort study), and 4697 pregnant women were selected by population-based sampling (retrospective cohort study). After application of exclusion criteria, data from 251 (prospective cohort study) and 232 (retrospective cohort study) malaria-infected and 158 (prospective cohort study) and 3650 (retrospective cohort study) noninfected women were evaluated.

Exposure

Malaria during pregnancy.

Main outcomes and measures

The primary end point was the incidence of altered head circumference in newborns delivered from malaria-infected mothers compared with that from noninfected mothers. Secondary end points included measures of placental pathology relative to newborn head circumference.

Results

In total, 4291 maternal-child pairs were analyzed. Among 409 newborns in the prospective cohort study, the mothers of 251 newborns had malaria during pregnancy, infected with Plasmodium vivax, Plasmodium falciparum, or both. Among 3882 newborns in the retrospective cohort study, 232 were born from mothers that had malaria during pregnancy. The prevalence of newborns with a small head (19 [30.7%] in the prospective cohort study and 30 [36.6%] in the retrospective cohort study) and the prevalence of microcephaly among newborns (5 [8.1%] in the prospective cohort study and 6 [7.3%] in the retrospective cohort study) were higher among newborns from women infected with P falciparum during pregnancy. Multivariate logistic regression analyses revealed that P falciparum infection during pregnancy represented a significant risk factor for the occurrence of small head circumference in newborns (prospective cohort study: odds ratio, 3.15; 95% CI, 1.52-6.53; P?=?.002; retrospective cohort study: odds ratio, 1.91; 95% CI, 1.21-3.04; P?=?.006). Placental pathologic findings corroborated this association, with more syncytial nuclear aggregates and inflammatory infiltrates occurring in placentas of newborns born with decreased head circumference.

Conclusions and relevance

This study indicates that falciparum malaria during pregnancy is associated with decreased head circumference in newborns, which is in turn associated with evidence of placental malaria.

SUBMITTER: Dombrowski JG

PROVIDER: S-EPMC6503507 | biostudies-literature | 2019 May

REPOSITORIES: biostudies-literature

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Publications

Association of Malaria Infection During Pregnancy With Head Circumference of Newborns in the Brazilian Amazon.

Dombrowski Jamille Gregório JG Souza Rodrigo Medeiros de RM Lima Flávia Afonso FA Bandeira Carla Letícia CL Murillo Oscar O Costa Douglas de Sousa DS Peixoto Erika Paula Machado EPM Cunha Marielton Dos Passos MDP Zanotto Paolo Marinho de Andrade PMA Bevilacqua Estela E Grisotto Marcos Augusto Grigolin MAG Pedroso de Lima Antonio Carlos AC Singer Julio da Motta JDM Campino Susana S Clark Taane Gregory TG Epiphanio Sabrina S Gonçalves Lígia Antunes LA Marinho Cláudio Romero Farias CRF

JAMA network open 20190503 5

<h4>Importance</h4>Malaria during pregnancy is associated with adverse events for the fetus and newborn, but the association of malaria during pregnancy with the head circumference of the newborn is unclear.<h4>Objective</h4>To investigate the association of malaria during pregnancy with fetal head growth.<h4>Design, setting, and participants</h4>Two cohort studies were conducted at the general maternity hospital of Cruzeiro do Sul (Acre, Brazil) in the Amazonian region. One cohort study prospec ...[more]

PMID: 31050780

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Dataset Information

Association of Malaria Infection During Pregnancy With Head Circumference of Newborns in the Brazilian Amazon.

Importance

Objective

Design, setting, and participants

Exposure

Main outcomes and measures

Results

Conclusions and relevance

Publications

Association of Malaria Infection During Pregnancy With Head Circumference of Newborns in the Brazilian Amazon.

Similar Datasets

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