Journal Article

Placental Malaria Increases Malaria Risk in the First 30 Months of Life

Norbert G. Schwarz, Ayola A. Adegnika, Lutz P. Breitling, Julian Gabor, Selidji T. Agnandji, Robert D. Newman, Bertrand Lell, Saadou Issifou, Maria Yazdanbakhsh, Adrian J. F. Luty, Peter G. Kremsner and Martin P. Grobusch

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 47, issue 8, pages 1017-1025
Published in print October 2008 | ISSN: 1058-4838
Published online October 2008 | e-ISSN: 1537-6591 | DOI:
Placental Malaria Increases Malaria Risk in the First 30 Months of Life

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  • Infectious Diseases
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Background. Plasmodium falciparum infection during pregnancy is associated with stillbirth, fetal growth restriction, and low birth weight. An additional consequence may be increased risk of malaria in early life, although the epidemiological evidence of this consequence is limited.

Methods. A cohort of 527 children were observed actively every month for 30 months after delivery. Offspring of mothers with microscopically detectable placental P. falciparum infection at the time of delivery were defined as exposed. The outcome measure was malaria (parasitemia and fever). Analyses were performed using Cox proportional hazard models and were stratified by gravidity.

Results. Overall, offspring of mothers with placental P. falciparum infection had a significantly higher risk of clinical malaria during the first 30 months of life (adjusted hazard ratio, 2.1; 95% confidence interval [CI], 1.2–3.7). The adjusted hazard ratio for offspring of multigravidae was 2.6 (95% CI, 1.3–5.3), and that for primigravidae was 1.5 (95% CI, 0.6–3.8). The offspring of placenta-infected primigravidae had no episodes of malaria during the first year of life.

Conclusions. Our findings show that active placental P. falciparum infection detected at delivery is associated with an ∼2-fold greater risk of malaria during early life, compared with noninfection. The fact that persons born to infected multigravidae rather than primigravidae appear to be at greater risk emphasizes the importance of preventing malaria in mothers of all gravidities.

Journal Article.  4448 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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