Fetal sex and risk of pregnancy-associated malaria in Plasmodium falciparum- endemic regions: a meta-analysis

Unger, Holger, Hadiprodjo, Anastasia Jessica, Gutman, Julie R., Briand, Valerie, Fievet, Nadine, Valea, Innocent, Tinto, Halidou, D’Alessandro, Umberto, Landis, Sarah H., terKuile, Feiko ORCID: https://orcid.org/0000-0003-3663-5617, Ouma, Peter, Oneko, Martina, Mwapasa, Victor, Slutsker, Laurence, Terlouw, Dianne, Kariuki, Simon, Ayisi, John, Nahlen, Bernard, Desai, Meghna, Madanitsa, Mwayi, Kalilani-Phiri, Linda, Ashorn, Per, Maleta, Kenneth, Tshefu-Kitoto, Antoinette, Mueller, Ivo, Stanisic, Danielle, Cates, Jordan, vanEijk, Anna ORCID: https://orcid.org/0000-0003-1635-1289, Ome-Kaius, Maria, Aitken, Elizabeth H. and Rogerson, Stephen J. (2023) 'Fetal sex and risk of pregnancy-associated malaria in Plasmodium falciparum- endemic regions: a meta-analysis'. Scientific Reports, Vol 13, Issue 1.

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Abstract

In areas of moderate to intense Plasmodium falciparum transmission, malaria in pregnancy remains a significant cause of low birth weight, stillbirth, and severe anaemia. Previously, fetal sex has been identified to modify the risks of maternal asthma, pre-eclampsia, and gestational diabetes. One study demonstrated increased risk of placental malaria in women carrying a female fetus. We investigated the association between fetal sex and malaria in pregnancy in 11 pregnancy studies conducted in sub-Saharan African countries and Papua New Guinea through meta-analysis using log binomial regression fitted to a random-effects model. Malaria infection during pregnancy and delivery was assessed using light microscopy, polymerase chain reaction, and histology. Five studies were observational studies and six were randomised controlled trials. Studies varied in terms of gravidity, gestational age at antenatal enrolment and bed net use. Presence of a female fetus was associated with malaria infection at enrolment by light microscopy (risk ratio 1.14 [95% confidence interval 1.04, 1.24]; P = 0.003; n = 11,729). Fetal sex did not associate with malaria infection when other time points or diagnostic methods were used. There is limited evidence that fetal sex influences the risk of malaria infection in pregnancy.

Item Type:	Article
Subjects:	WC Communicable Diseases > Tropical and Parasitic Diseases > WC 750 Malaria WQ Obstetrics > Pregnancy > WQ 200 General works
Faculty: Department:	Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI):	https://doi.org/10.1038/s41598-023-37431-3
SWORD Depositor:	JISC Pubrouter
Depositing User:	JISC Pubrouter
Date Deposited:	27 Jun 2023 08:45
Last Modified:	27 Jun 2023 08:45
URI:	https://archive.lstmed.ac.uk/id/eprint/22710

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