Prediction of Plasmodium falciparum placental infection according to the time of infection during pregnancy.
Malarial infection during pregnancy leads to placental infection, a known risk factor for low birth weight. Whether the stage of pregnancy at infection has a differential influence on these effects is not clearly known, but may be of importance for prevention strategies, including intermittent preventive treatment of pregnant women. Malaria infection during early (before 20 weeks), middle (20-28 weeks), or late (after 28 weeks) pregnancy was evaluated by logistic regression and receiver operating characteristics analysis in relation to placental infection in pregnant Senegalese women. Plasmodium falciparum infections during late pregnancy are strongly related to placental infection, as well as those that occur in middle pregnancy. Knowledge of parasitological events over the entire duration of pregnancy permits a highly accurate prediction of placental infection. Not only malaria infections during late pregnancy increase the likelihood of placental infection. The current policy of intermittent preventive treatment of pregnant women, which implies an initial antimalarial cure after 20 weeks of pregnancy, will not avoid early infections. An earlier initiation of malaria prevention might improve its efficacy.
Cottrell
Gilles
G
Institut de Recherche pour le Développement (IRD), UR010, Mother and Child Health in the Tropics, Université Paris Descartes, Paris, France.
Deloron
Philippe
P
Fievet
Nadine
N
Sow
Sokhna
S
Gaye
Oumar
O
Le Hesran
Jean-Yves
JY
D000328:Adult; D000818:Animals; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D016015:Logistic Models; D016778:Malaria, Falciparum / Q000175:diagnosis* / Q000517:prevention & control; D008954:Models, Biological; D010920:Placenta / Q000469:parasitology*; D010963:Plasmodium falciparum / Q000302:isolation & purification*; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic / Q000175:diagnosis* / Q000517:prevention & control; D012372:ROC Curve; D012307:Risk Factors; D012675:Senegal; D013997:Time Factors