title: The effect of malarial infection on maternal-fetal outcome in Ecuador.
abstract: OBJECTIVE
  To describe maternal and fetal outcome among pregnancies complicated with malarial infection.
  
  
  METHODS
  Charts of pregnancies complicated with malarial infection were reviewed. Parasital etiology and maternal/fetal data was analyzed.
  
  
  RESULTS
  During the year 2001, at the Enrique C. Sotomayor Obstetrics and Gynecology Hospital, Guayaquil-Ecuador, 80 pregnancies complicated with malarial infection were admitted for treatment. This rendered an incidence of 2.1 per 1,000 live births (80/37,579). Mean maternal age was 25.2 +/- 6.7 years and the 19-29 age group was the most frequently affected (50%). On admittance, fever, chills, jaundice and anemia was present in 97.5%, 78.8%, 38.8% and 60% respectively. Falciparum was the most frequently presenting species (56.3%). Patients admitted at < 20 weeks gestation (n = 17) had a 76.5% and 82.4% abortion and adverse fetal outcome rate respectively. Among those admitted at 20-36 weeks (n = 55) the rates for preterm birth, intrauterine fetal death, low birthweight (LBW) and small-for-gestational age (SGA) were 34.5%, 11%, 40.8% and 48.9% respectively. Among patients admitted > 36 weeks, 87.5% (7/8) ended in a live term delivery. Adolescents presented a higher rate of anemia and SGA neonates. The overall (n = 80) abortion, preterm delivery and intrauterine fetal demise rates were 16.3%, 25% and 8.8% respectively. Chloroquine effectively treated 98.8% of cases and there was one maternal death due to falciparum infection.
  
  
  CONCLUSIONS
  In this Ecuadorian population, malarial infection complicating gestation was associated to adverse maternal-fetal outcome, which was more evident among teenagers and pregnancies presenting malaria at an earlier gestational age.
authors.affiliation: High Risk Pregnancy Unit of the Enrique C. Sotomayor Obstetrics and Gynecology Hospital, Guayaquil, Ecuador.
authors.forename: E
authors.initials: E
authors.lastname: Espinoza
authors.forename: L
authors.initials: L
authors.lastname: Hidalgo
authors.forename: P
authors.initials: P
authors.lastname: Chedraui
mesh_terms: D000328:Adult; D000367:Age Factors; D004484:Ecuador / Q000453:epidemiology; D005260:Female; D005313:Fetal Death; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D008288:Malaria / Q000453:epidemiology* / Q000209:etiology / Q000469:parasitology; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic / Q000453:epidemiology* / Q000209:etiology / Q000469:parasitology; D011256:Pregnancy Outcome