Submicroscopic Plasmodium falciparum malaria and low birth weight in an area of unstable malaria transmission in Central Sudan.
Submicroscopic Plasmodium falciparum malaria and low birth weight in an area of unstable malaria transmission in Central Sudan.
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DOI：
10.1186/1475-2875-12-172
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发表时间：
2013-05-28
期刊：
影响因子：
3
通讯作者：
Adam I
中科院分区：
文献类型：
--
作者：
Mohammed AH;Salih MM;Elhassan EM;Mohmmed AA;Elzaki SE;El-Sayed BB;Adam I
疟疾经常发生在热带地区的孕妇中，是导致母亲贫血和婴儿出生体重低的主要原因。关于孕期亚微观层面的疟疾感染及其在婴儿LBW分娩的数据很少。在苏丹中部的Medani医院进行了一项病例对照研究(每组87例)。研究对象为低出生体重儿分娩的妇女，婴儿体重为 <； 2500克。对照组为未生低出生体重儿的临产妇女。通过结构化问卷收集两组患者的产科特征和医学特征。通过镜检血膜分析、胎盘组织学和聚合酶链式反应(PCR)对病例和对照进行疟疾调查。对孕妇外周血、胎盘和脐带样本进行了显微镜和聚合酶链式反应分析。出生后立即记录婴儿体重。未从任何妇女(病例或对照)处获得恶性疟原虫阳性血片。通过组织学检查，病例组和对照组中分别有27例(31.0%)和22例(25.3%)(P = 0.500)有胎盘疟疾感染。与对照组相比，病例的亚微观疟疾感染率显著升高，分别为24例(27.6%)和6例(7.0%)，P <； 0.001。多因素分析显示，胎盘疟疾感染与低出生体重无关，而恶性疟原虫亚显微感染(OR = 6.89，95%CI = 2.2~2 0.8；P = 0.001)或组织学与亚显微感染的组合(OR = 2.45，95%CI = 1.2~4.9；P = 0.012)与低出生体重显著相关。在苏丹中部，如果孕妇患有亚显微感染，而不是胎盘疟疾的组织学诊断，她们分娩LBW的风险更高。
Malaria, which frequently occurs in pregnant women in the tropics, is a leading cause of maternal anaemia and low birth weight (LBW) in infants. Few data exist concerning malaria infections that are present at submicroscopic levels during pregnancy and their LBW delivery in babies. A case–control study (87 in each group) was conducted at the Medani Hospital, Central Sudan. Cases were women who had LBW deliveries where the infants weighed < 2,500 g. Controls were parturient women without having LBW babies. Obstetrical and medical characteristics were gathered from both groups through structured questionnaires. Both cases and controls were investigated for malaria using microscopic blood film analysis, placental histology and polymerase chain reaction (PCR). Microscopic and PCR analyses were conducted on maternal peripheral blood, placenta, and umbilical cord samples. Infant weights were recorded immediately after birth. Plasmodium falciparum-positive blood films were not obtained from any of the women (cases or controls). Twenty-seven (31.0%) versus 22 (25.3%) (P = 0.500) of the cases and controls, respectively, had placental malaria infections as determined by histological examination. In comparison to the controls, the submicroscopic malaria infection prevalence rates were significantly higher in the cases; 24 (27.6%) vs six (7.0%), P < 0.001. Multivariate analysis showed that while malaria infection of the placenta (based on histology) was not associated with LBW, submicroscopic P. falciparum infection (OR = 6.89, 95% CI = 2.2–20.8; P = 0.001), or a combination of histologically determined and submicroscopic infections (OR = 2.45, 95% CI = 1.2–4.9; P = 0.012), were significantly associated with LBW. In Central Sudan, pregnant women were at a higher risk of having an LBW delivery if they had submicroscopic infections rather than a histological diagnosis of placental malaria.
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作者：
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