title: Anthropometry of fetal growth in rural Malawi in relation to maternal malaria and HIV status.
abstract: OBJECTIVE
  To describe fetal growth centiles in relation to maternal malaria and HIV status, using cross sectional measurements at birth.
  
  
  METHODS
  A cross sectional study of pregnant women and their babies. Data on maternal socioeconomic status and current pregnancy, including HIV status and newborn anthropometry, were collected. Malaria parasitaemia was assessed in maternal peripheral and placental blood, fetal haemoglobin was measured in cord blood, and maternal HIV status was determined.
  
  
  METHODS
  Two district hospitals in rural southern Malawi, between March 1993 and July 1994.
  
  
  METHODS
  Newborn weight, length, Rohrer's ponderal index.
  
  
  RESULTS
  Maternal HIV (adjusted odds ratio (AOR) 1.76 (95% confidence interval 1.04 to 2.98)) and first pregnancy (AOR 1.83 (1.10 to 3.05)) were independently associated with low weight for age. Placental or peripheral parasitaemia at delivery (AOR 1.73 (1.02 to 2.88)) and primigravidae (AOR 2.13 (1.27 to 3.59)) were independently associated with low length for age. Maternal malaria at delivery and primiparity were associated with reduced newborn weight and length but not with disproportionate growth. Maternal HIV infection was associated only with reduced birth weight. The malaria and parity effect occurred throughout gestational weeks 30-40, but the HIV effect primarily after 38 weeks gestation.
  
  
  CONCLUSIONS
  Fetal growth retardation in weight and length commonly occurs in this highly malarious area and is present from 30 weeks gestation. A maternal HIV effect on fetal weight occurred after 38 weeks gestation.
authors.affiliation: Child and Reproductive Health Group, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK.
authors.forename: B F
authors.initials: BF
authors.lastname: Kalanda
authors.forename: S
authors.initials: S
authors.lastname: van Buuren
authors.forename: F H
authors.initials: FH
authors.lastname: Verhoeff
authors.forename: B J
authors.initials: BJ
authors.lastname: Brabin
mesh_terms: D001724:Birth Weight / Q000502:physiology; D003430:Cross-Sectional Studies; D005260:Female; D047109:Fetal Development / Q000502:physiology*; D005865:Gestational Age; D020073:Gravidity / Q000502:physiology; D006679:HIV Seropositivity / Q000453:epidemiology* / Q000503:physiopathology; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age / Q000502:physiology; D008288:Malaria / Q000453:epidemiology* / Q000503:physiopathology; D008295:Malawi / Q000453:epidemiology; D008297:Male; D018512:Parasitemia / Q000453:epidemiology; D010922:Placenta Diseases / Q000469:parasitology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology* / Q000503:physiopathology; D015597:Pregnancy Complications, Parasitic / Q000503:physiopathology; D012424:Rural Population
references.citation: AIDS. 1998 Apr 16;12(6):643-50
references.pmid: 9583605
references.citation: Bull World Health Organ. 1977;55(4):489-98
references.pmid: 304391
references.citation: Bull World Health Organ. 1983;61(6):1005-16
references.pmid: 6370484
references.citation: Am J Trop Med Hyg. 1984 Jul;33(4):517-25
references.pmid: 6383091
references.citation: Acta Paediatr Scand Suppl. 1985;319:21-5
references.pmid: 3914185
references.citation: Acta Paediatr Scand Suppl. 1985;319:7-16
references.pmid: 3868926
references.citation: Am J Obstet Gynecol. 1989 Aug;161(2):271-7
references.pmid: 2669484
references.citation: Am J Obstet Gynecol. 1990 Jul;163(1 Pt 1):151-7
references.pmid: 2375339
references.citation: J Clin Epidemiol. 1992 Nov;45(11):1257-63
references.pmid: 1432007
references.citation: Ann Trop Paediatr. 1992;12(3):303-10
references.pmid: 1280047
references.citation: Am J Trop Med Hyg. 1993 May;48(5):603-9
references.pmid: 8517479
references.citation: Pediatr Infect Dis J. 1994 Feb;13(2):94-100
references.pmid: 8190558
references.citation: Ultrasound Obstet Gynecol. 1995 Sep;6(3):168-74
references.pmid: 8521065
references.citation: J Pediatr. 1996 Jan;128(1):58-69
references.pmid: 8551422
references.citation: Obstet Gynecol Surv. 1997 Feb;52(2):139-49
references.pmid: 9027913
references.citation: Stat Med. 1998 Feb 28;17(4):407-29
references.pmid: 9496720
references.citation: Eur J Clin Nutr. 1998 Jan;52 Suppl 1:S83-93
references.pmid: 9511024
references.citation: Ann Trop Paediatr. 1997 Dec;17(4):333-42
references.pmid: 9578793
references.citation: Ann Trop Med Parasitol. 1998 Mar;92(2):141-50
references.pmid: 9625909
references.citation: N Engl J Med. 1999 Apr 22;340(16):1234-8
references.pmid: 10210706
references.citation: Int J Epidemiol. 1999 Jun;28(3):475-8
references.pmid: 10405851
references.citation: Trans R Soc Trop Med Hyg. 1999 Jul-Aug;93(4):423-6
references.pmid: 10674095
references.citation: J Infect Dis. 2000 May;181(5):1740-5
references.pmid: 10823776
references.citation: Eur J Clin Nutr. 2001 Aug;55(8):682-9
references.pmid: 11477467
references.citation: Pediatrics. 2002 Jan;109(1):45-60
references.pmid: 11773541
references.citation: Radiology. 2002 Apr;223(1):153-61
references.pmid: 11930060
references.citation: Trends Parasitol. 2003 Jan;19(1):39-43
references.pmid: 12488225
references.citation: AIDS. 2004 Jan 23;18(2):344-7
references.pmid: 15075561
references.citation: Placenta. 2004 May;25(5):359-78
references.pmid: 15081631
references.citation: J Obstet Gynaecol Br Commonw. 1968 Sep;75(9):903-16
references.pmid: 5685276
references.citation: Pediatrics. 1970 Jun;45(6):937-44
references.pmid: 5422116
references.citation: Clin Obstet Gynecol. 1974 Sep;17(3):37-52
references.pmid: 4606598
references.citation: J Obstet Gynaecol Br Commonw. 1974 Dec;81(12):956-67
references.pmid: 4452923
references.citation: Am J Obstet Gynecol. 1982 Mar 1;142(5):577-88
references.pmid: 7036747