Placental and Neonatal Outcome in Maternal Malaria.
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Date
2014-04
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Abstract
Objective: Primary: To determine the incidence of congenital
malaria in a cohort of pregnant women in a hyper-endemic area
of central India. Secondary: (1) To find out the placental weight
and placental malaria positivity, and to assess fetal and neonatal
outcome in terms of survival, mean hemoglobin and mean birth
weight.
Design: Prospective observational study.
Setting: Maternity and neonatal ward of a tertiary level hospital
attached to a medical college located in Rewa, Madhya Pradesh,
India.
Participants: Near term and term pregnant women admitted in
the maternity ward with a singleton pregnancy, whose neonates
were available for examination till at least 6 hours after birth.
Methods: Thick and thin blood smear were examined for
malarial parasites from mothers prior to delivery. Based on the
results of peripheral smear they were divided into ‘exposed
group’ (peripheral smear positive for malaria parasite) and
unexposed group’ (smear negative for malaria parasite). These
groups were then followed prospectively till delivery and
subsequently till the mother and the neonates were discharged
from the hospital.
Outcome variables: Primary: Presence of asexual parasite in
neonate. Secondary: Placental weight, presence of asexual
malarial parasite in placenta, still births, early neonatal deaths,
mean birth weight and mean hemoglobin.
Results: Seventy-two (35.5%) of 203 blood smears of near
term and term pregnant women were found positive for malaria
parasite (60 P. vivax and 12 P. falciparum); rest 131 comprised
the unexposed group. Six (2.95%) neonates had parasitemia (4
P. vivax and 2 P. falciparum). Of the 203 smears made from
placental blood, 24 (11.8%) were positive for malaria parasite.
The mean (SD) birth weight [2300 (472) g vs 2430 (322) g;
P=0.98], proportion of preterm babies (6.9% vs 8.4%, P=0.71),
incidence of still birth (4.2% vs 3.0%, P=1.0) and early neonatal
death (2.8% vs 3.0%, P=1.0) were not significantly different
between the exposed and unexposed group.
Conclusions: The incidence of congenital malaria is low
despite high maternal smear positivity for malaria.
Description
Keywords
Low birth weight, Malaria, Placenta
Citation
Singh Jyoti, Soni Dharmendra, Mishra Devendra, Singh H P, Bijesh S. Placental and Neonatal Outcome in Maternal Malaria. Indian Pediatrics. 2014 Apr; 51(4): 285-288.