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Adverse birth outcomes in a malarious area

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Kalanda, Boniface F., Verhoeff, Francine H., Chimsuku, L., Harper, G. and Brabin, Bernard (2006) 'Adverse birth outcomes in a malarious area'. Epidemiology and Infection, Vol 134, Issue 3, pp. 659-666.

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Abstract

To determine factors associated with fetal growth, preterm delivery and stillbirth in an area of high malaria transmission in Southern Malawi, a cross-sectional study of pregnant women attending and delivering at two study hospitals was undertaken. A total of 243 (17(.)3%) babies were preterm and 54 (3(.)7%) stillborn. Intra-uterine growth retardation (IUGR) occurred in 285 (20(.)3%), of whom 109 (38(.)2%) were low birthweight and 26 (9(.)1%) preterm. Factors associated with IUGR were maternal short stature [adjusted odds ratio (AOR) 1(.)6, 95 % confidence interval (0) 1(.)0-2(.)5]; primigravidae (AOR 1(.)9, 95 % CI 1(.)4-2(.)7); placental or peripheral malaria at delivery (AOR 1(.)4, 95% CI 1(.)0-1(.)9) and maternal anaemia at recruitment (Hb < 8 g/dl) (AOR 1-9, 95% CI 1(.)3-2(.)7). Increasing parasite density in the placenta was associated with both IUGR (P = 0(.)008) and prematurity (P = 0(.)02). Factors associated with disproportionate fetal growth were maternal malnutrition [mid-upper arm circumference (MUAC) < 23 cm, AOR 1(.)9, 95% CI 1(.)0-3(.)7] and primigravidae (AOR 1(.)8, 95% CI 1(.)0-3(.)1). Preterm delivery and stillbirth were associated with < 5 antenatal care visits (AOR 2(.)2, 95 % CI 1(.)3-3(.)7 and AOR 3(.)1, 95 % CI 1(.)4-7(.)0 respectively) and stillbirth with a positive Venereal Disease Research Laboratory (VDRL) test (AOR 4(.)7, 95 % CI 1(.)5-14(.)8). Interventions to reduce poor pregnancy outcomes must reduce the burden of malaria in pregnancy, improve antenatal care and maternal malnutrition.

Item Type: Article
Uncontrolled Keywords: intrauterine growth-retardation placental malaria gestational-age preterm delivery infant growth rural malawi fetal anemia pregnancy weight infection
Subjects: WA Public Health > Preventive Medicine > WA 110 Prevention and control of communicable diseases. Transmission of infectious diseases
WB Practice of Medicine > Medical Climatology > WB 710 Diseases of geographic areas
WD Disorders of Systemic, Metabolic or Environmental Origin, etc > Nutrition Disorders > WD 105 Deficiency diseases
WQ Obstetrics > WQ 100 General works
WQ Obstetrics > WQ 20 Research (General)
WQ Obstetrics > Pregnancy > WQ 200 General works
WQ Obstetrics > Pregnancy Complications > WQ 240 Pregnancy complications (General)
WQ Obstetrics > Pregnancy Complications > WQ 256 Infectious diseases
WS Pediatrics > Child Care. Nutrition. Physical Examination > WS 115 Nutritional requirements. Nutrition disorders
Faculty: Department: Groups (2002 - 2012) > Child & Reproductive Health Group
Digital Object Identifer (DOI): https://doi.org/10.1017/S0950268805005285
Depositing User: Sarah Lewis-Newton
Date Deposited: 24 Feb 2011 11:28
Last Modified: 06 Feb 2018 13:02
URI: https://archive.lstmed.ac.uk/id/eprint/1526

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