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Malaria during pregnancy and foetal haematological status in Blantyre, Malawi

Abrams, Elizabeth T., Kwiek, Jesse K., Mwapasa, Victor, Kamwendo, Deborah D., Tadesse, Eyob, Lema, Valentino M., Molyneux, Malcolm E., Rogerson, Stephen J. and Meshnick, Steven R. (2005) 'Malaria during pregnancy and foetal haematological status in Blantyre, Malawi'. Malaria Journal, Vol 4, p. 39.

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Abstract

Background: Although maternal anaemia often stems from malaria infection during pregnancy, its effects
on foetal haemoglobin levels are not straightforward. Lower-than-expected cord haemoglobin values in
malarious versus non-malarious regions were noted by one review, which hypothesized they resulted from
foetal immune activation to maternal malaria. This study addressed this idea by examining cord
haemoglobin levels in relation to maternal malaria, anaemia, and markers of foetal immune activation.
Methods: Cord haemoglobin levels were examined in 32 malaria-infected and 58 uninfected women in
Blantyre, Malawi, in relation to maternal haemoglobin levels, malaria status, and markers of foetal
haematological status, hypoxia, and inflammation, including TNF-α, TGF-β, and ferritin. All women were
HIV-negative.
Results: Although malaria was associated with a reduction in maternal haemoglobin (10.8 g/dL vs. 12.1 g/
dL, p < 0.001), no reduction in cord haemoglobin and no significant relationship between maternal and
cord haemoglobin levels were found. Cord blood markers of haematological and hypoxic statuses did not
differ between malaria-infected and uninfected women. Maternal malaria was associated with decreased
TGF-β and increased cord ferritin, the latter of which was positively correlated with parasitaemia (r =
0.474, p = 0.009). Increased cord ferritin was associated with significantly decreased birth weight and
gestational length, although maternal and cord haemoglobin levels and malaria status had no effect on birth
outcome.
Conclusion: In this population, cord haemoglobin levels were protected from the effect of maternal
malaria. However, decreased TGF-β and elevated ferritin levels in cord blood suggest foetal immune
activation to maternal malaria, which may help explain poor birth outcomes.

Item Type: Article
Additional Information: Published: 25 August 2005. 8 pages (page numbers not for citation purposes. The electronic version of this article is the complete one and can be found online at: http://www.malariajournal.com/content/4/1/39
Uncontrolled Keywords: INTRAUTERINE GROWTH-RETARDATION; PLASMODIUM-FALCIPARUM MALARIA; NECROSIS-FACTOR-ALPHA; BIRTH-WEIGHT; ERYTHROPOIETIN PRODUCTION; PLACENTAL MALARIA; IMMUNE-RESPONSES; IRON STATUS; ANEMIA; CHILDREN
Subjects: ?? R1 ??
WA Public Health > Health Problems of Special Population Groups > WA 310 Maternal welfare
WC Communicable Diseases > Tropical and Parasitic Diseases > WC 750 Malaria
WQ Obstetrics > Pregnancy Complications > WQ 256 Infectious diseases
Faculty: Department: Groups (2002 - 2012) > Clinical Group
Digital Object Identifer (DOI): https://doi.org/10.1186/1475-2875-4-39
Related URLs:
Depositing User: Ms Julia Martin
Date Deposited: 04 Jul 2008 14:59
Last Modified: 09 Aug 2017 01:02
URI: http://archive.lstmed.ac.uk/id/eprint/965

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