Relationships between infection with Plasmodium falciparum during pregnancy, measures of placental malaria, and adverse birth outcomes.
Relationships between infection with Plasmodium falciparum during pregnancy, measures of placental malaria, and adverse birth outcomes.
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DOI：
10.1186/s12936-017-2040-4
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发表时间：
2017-10-05
期刊：
影响因子：
3
通讯作者：
Gaw SL
中科院分区：
文献类型：
--
作者：
Kapisi J;Kakuru A;Jagannathan P;Muhindo MK;Natureeba P;Awori P;Nakalembe M;Ssekitoleko R;Olwoch P;Ategeka J;Nayebare P;Clark TD;Rizzuto G;Muehlenbachs A;Havlir DV;Kamya MR;Dorsey G;Gaw SL
妊娠期疟疾与孕产妇发病率、胎盘疟疾和不良分娩结局有关。然而，关于妊娠期间疟疾纵向测量、胎盘疟疾测量和出生结局之间关系的数据有限。这是一项嵌套观察性研究，其数据来自一项随机对照试验，282名参与者参与了妊娠期间间歇性预防治疗，评估了胎盘疟疾和分娩结局。未感染艾滋病毒的孕妇在妊娠12-20周时登记。使用被动监测和每月使用环介导等温扩增（LAMP）检测无症状寄生虫血症来测量妊娠期间的症状性疟疾。胎盘疟疾被定义为显微镜下胎盘血中存在寄生虫，用LAMP检测胎盘血中的寄生虫，或寄生虫或色素的组织病理学证据。不良出生结局包括低出生体重（LBW）、早产（PTB）和小于胎龄（SGA）婴儿。282名妇女被分成三组，代表妊娠期间疟疾负担的增加。52例（18.4%）孕妇孕期未发生有症状的疟疾或无症状寄生虫病，157例（55.7%）孕妇孕期疟疾负担低（0 ~ 1次有症状的疟疾发作，LAMP+的样本占50%以下），73例（25.9%）孕妇孕期疟疾负担高（≥2次有症状的疟疾发作，LAMP+的样本占50%以上）。与其他两组相比，血液镜检和LAMP结果显示，疟疾负担高的妇女胎盘疟疾的风险增加[aRR分别为14.2（1.80-111.6）和4.06(1.73-9.51)]。与妊娠期无疟疾暴露的妇女相比，低负荷组和高负荷组胎盘疟疾的组织病理学风险更高[aRR分别= 3.27（1.32-8.12）和7.07(2.84-17.6)]。通过任何方法检测胎盘寄生虫都与PTB显著相关[aRR 5.64(1.46-21.8)]，并且无论妊娠期间疟疾负担水平如何，LBW和SGA的风险都有增加的趋势。妊娠期间较高的疟疾负担与胎盘疟疾有关，并与胎盘中寄生虫的检测一起与不良分娩结局的风险增加有关。本文的在线版本（doi:10.1186/s12936-017-2040-4）包含补充材料，可供授权用户使用。
Malaria in pregnancy has been associated with maternal morbidity, placental malaria, and adverse birth outcomes. However, data are limited on the relationships between longitudinal measures of malaria during pregnancy, measures of placental malaria, and birth outcomes. This is a nested observational study of data from a randomized controlled trial of intermittent preventive therapy during pregnancy among 282 participants with assessment of placental malaria and delivery outcomes. HIV-uninfected pregnant women were enrolled at 12–20 weeks of gestation. Symptomatic malaria during pregnancy was measured using passive surveillance and monthly detection of asymptomatic parasitaemia using loop-mediated isothermal amplification (LAMP). Placental malaria was defined as either the presence of parasites in placental blood by microscopy, detection of parasites in placental blood by LAMP, or histopathologic evidence of parasites or pigment. Adverse birth outcomes assessed included low birth weight (LBW), preterm birth (PTB), and small for gestational age (SGA) infants. The 282 women were divided into three groups representing increasing malaria burden during pregnancy. Fifty-two (18.4%) had no episodes of symptomatic malaria or asymptomatic parasitaemia during the pregnancy, 157 (55.7%) had low malaria burden (0–1 episodes of symptomatic malaria and < 50% of samples LAMP+), and 73 (25.9%) had high malaria burden during pregnancy (≥ 2 episodes of symptomatic malaria or ≥ 50% of samples LAMP+). Women with high malaria burden had increased risks of placental malaria by blood microscopy and LAMP [aRR 14.2 (1.80–111.6) and 4.06 (1.73–9.51), respectively], compared to the other two groups combined. Compared with women with no malaria exposure during pregnancy, the risk of placental malaria by histopathology was higher among low and high burden groups [aRR = 3.27 (1.32–8.12) and aRR = 7.07 (2.84–17.6), respectively]. Detection of placental parasites by any method was significantly associated with PTB [aRR 5.64 (1.46–21.8)], and with a trend towards increased risk for LBW and SGA irrespective of the level of malaria burden during pregnancy. Higher malaria burden during pregnancy was associated with placental malaria and together with the detection of parasites in the placenta were associated with increased risk for adverse birth outcomes. Trial Registration Current Controlled Trials Identifier NCT02163447 The online version of this article (doi:10.1186/s12936-017-2040-4) contains supplementary material, which is available to authorized users.
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在疟疾流行环境中对疟疾寄生虫血症的高度敏感性检测：在乌干达偏远诊所中新的环路介导的等温扩增试剂盒的性能。
DOI：
10.1093/infdis/jit184
发表时间：
2013-08-15
期刊：
The Journal of infectious diseases
影响因子：
--
作者：
Hopkins H;González IJ;Polley SD;Angutoko P;Ategeka J;Asiimwe C;Agaba B;Kyabayinze DJ;Sutherland CJ;Perkins MD;Bell D
通讯作者：
Bell D
影响因子：
3.7
作者：
Kalilani-Phiri, Linda;Thesing, Phillip C.;Laufer, Miriam K.
通讯作者：
Laufer, Miriam K.
影响因子：
3
作者：
Tegegne, Banchamlak;Getie, Sisay;Pillai, Dylan R.
通讯作者：
Pillai, Dylan R.
影响因子：
3.7
作者：
Rijken, Marcus J.;Papageorghiou, Aris T.;McGready, Rose
通讯作者：
McGready, Rose
影响因子：
8
作者：
Pulver, Laurie S.;Guest-Warnick, Ginger;Young, Paul C.
通讯作者：
Young, Paul C.