Risk factors for fetal anaemia in a malarious area of Malawi

Brabin, Bernard, Kalanda, Boniface F., Verhoeff, Francine H., Chimsuku, L. H. and Broadhead, R. L. (2004) 'Risk factors for fetal anaemia in a malarious area of Malawi'. Annals of Tropical Paediatrics, Vol 24, Issue 4, pp. 311-321.

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Abstract

The prevalence of infants born with low cord haemoglobin (fetal anaemia) is high in areas where malaria and iron deficiency anaemia in pregnancy are common. The objective of the present study was to determine risk factors for fetal anaemia in an area of high malaria transmission in southern Malawi. A case control study was undertaken with fetal anaemia defined as cord haemoglobin (Hb) <12.5 g/dl. Between March 1993 and July 1994, pregnant women attending the study hospitals for the first time in that pregnancy were enrolled. Data on socio-economic status, anthropometry, previous obstetric history and current pregnancy were collected. Malaria parasitaemia, Hb levels and iron status were measured in maternal blood at recruitment and delivery and in umbilical venous blood. Fetal anaemia occurred in 23.4% of babies. Mean (SD) cord Hb was 13.6 g/dl (1.83). Factors associated with fetal anaemia were: birth in the rainy season [adjusted odds ratio (AOR) 2.33, 95% CI 1.73-3.14], pre-term delivery (AOR 1.60, 1.03-2.49), infant Hb <14 g/dl at 24 hours (AOR 2.35, 1.20-4.59), maternal Hb at delivery <8 g/dl (AOR 1.61,1.10-2.42) or <11 g/dl (AOR 1.60, 1.10-2.31). A higher prevalence of fetal anaemia occur-red with increasing peripheral Plasmodium falciparum parasite density (p=0.03) and geometric mean placental parasite densities were higher in babies with fetal anaemia than in those without (3331 vs 2152 parasites/mul, p=0.07). Interventions should aim to reduce fetal anaemia by improving malaria and anaemia control in pregnancy and by addressing the determinants of pre-term delivery.

Item Type:	Article
Uncontrolled Keywords:	infected pregnant-women low-birth-weight maternal anemia iron status prevalence infants born deficiency exposure placenta
Subjects:	WC Communicable Diseases > Tropical and Parasitic Diseases > WC 750 Malaria WH Hemic and Lymphatic Systems > Hematologic Diseases. Immunologic Factors. Blood Banks > WH 155 Anemia WQ Obstetrics > Pregnancy Complications > WQ 252 Hematologic complications WS Pediatrics > Diseases of Children and Adolescents > By System > WS 300 Hemic and lymphatic system
Faculty: Department:	Groups (2002 - 2012) > Child & Reproductive Health Group
Digital Object Identifer (DOI):	https://doi.org/10.1179/027249304225019136
Depositing User:	Ms Julia Martin
Date Deposited:	07 Dec 2011 10:39
Last Modified:	06 Feb 2018 13:03
URI:	https://archive.lstmed.ac.uk/id/eprint/2118

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