Effects of malaria during pregnancy on infant mortality in an area of low malaria transmission
Effects of malaria during pregnancy on infant mortality in an area of low malaria transmission
复制标题
DOI：
10.1093/aje/154.5.459
复制
发表时间：
2001-09-01
影响因子：
5
通讯作者：
Nosten, F
中科院分区：
文献类型：
--
作者：
Luxemburger, C;McGready, R;Nosten, F
孕期疟疾会降低新生儿体重，而低出生体重是婴儿死亡率的主要决定因素。作者估计了孕期疟疾对居住在泰国的克伦族人口婴儿死亡率的影响。1993至1996年间，每周对1,495名母亲及其婴儿进行跟踪调查，从母亲入住产前诊所到婴儿一岁生日。孕期恶性疟疾和间日疟都与低出生体重有关，但不会缩短妊娠。分娩前一周的发烧疾病与早产有关。早产和足月低出生体重和分娩前一周发烧与新生儿死亡率相关。接近临产时的母亲发烧也与1至3个月大婴儿的死亡有关，而婴儿后期死亡的风险因素尚不能确定。因此，孕期疟疾通过降低出生体重来增加新生儿死亡率，而出生前一周的发烧除了导致早产外，还具有进一步的独立影响。预防孕期疟疾，从而预防疟疾所致的低出生体重，应提高婴儿的存活率。
Malaria during pregnancy reduces birth weight, and low birth weight is a major determinant of infant mortality. The authors estimated the impact of malaria during pregnancy on infant mortality in a Karen population living in Thailand. Between 1993 and 1996, a cohort of 1,495 mothers and their infants was followed weekly from admission of the mother to antenatal clinics until the first birthday of the infant. Both falciparum malaria and vivax malaria during pregnancy were associated with low birth weight but did not shorten gestation. Febrile illness in the week before delivery was associated with premature birth. Preterm and full-term low birth weight and fever in the week before delivery were associated with neonatal mortality. Maternal fevers close to term were also associated with the deaths of infants aged between 1 and 3 months, whereas no risk factors could be identified for deaths that occurred later in infancy. Thus, malaria during pregnancy increased neonatal mortality by lowering birth weight, whereas fever in the week before birth had a further independent effect in addition to inducing premature birth. The prevention of malaria in pregnancy and, thus, of malaria-attributable low birth weight should increase the survival of young babies.