title: Impact of malaria at the end of pregnancy on infant mortality and morbidity.
abstract: BACKGROUND
  There is some consensus that malaria in pregnancy may negatively affect infant's mortality and malaria morbidity, but there is less evidence concerning the factors involved.
  
  
  METHODS
  A total of 1030 Mozambican pregnant women were enrolled in a randomized, placebo-controlled trial of intermittent preventive treatment with sulfadoxine-pyrimethamine, and their infants were followed up throughout infancy. Overall mortality and malaria morbidity rates were recorded. The association of maternal and fetal risk factors with infant mortality and malaria morbidity was assessed.
  
  
  RESULTS
  There were 58 infant deaths among 997 live-born infants. The risk of dying during infancy was increased among infants born to women with acute placental infection (odds ratio [OR], 5.08 [95% confidence interval (CI), 1.77-14.53)], parasitemia in cord blood (OR, 19.31 [95% CI, 4.44-84.02]), low birth weight (OR, 2.82 [95% CI, 1.27-6.28]) or prematurity (OR, 3.19 [95% CI, 1.14-8.95]). Infants born to women who had clinical malaria during pregnancy (OR, 1.96 [95% CI, 1.13-3.41]) or acute placental infection (OR, 4.63 [95% CI, 2.10-10.24]) had an increased risk of clinical malaria during infancy.
  
  
  CONCLUSIONS
  Malaria infection at the end of pregnancy and maternal clinical malaria negatively impact survival and malaria morbidity in infancy. Effective clinical management and prevention of malaria in pregnancy may improve infant's health and survival.
authors.affiliation: Barcelona Centre for International Health Research and Department of Pathology, Hospital Clinic, Institut d'Investigacions Biomèdicas August Pi i Sunyer, Universitat de Barcelona, Spain. abardaji@clinic.ub.es
authors.forename: Azucena
authors.initials: A
authors.lastname: Bardají
authors.forename: Betuel
authors.initials: B
authors.lastname: Sigauque
authors.forename: Sergi
authors.initials: S
authors.lastname: Sanz
authors.forename: María
authors.initials: M
authors.lastname: Maixenchs
authors.forename: Jaume
authors.initials: J
authors.lastname: Ordi
authors.forename: John J
authors.initials: JJ
authors.lastname: Aponte
authors.forename: Samuel
authors.initials: S
authors.lastname: Mabunda
authors.forename: Pedro L
authors.initials: PL
authors.lastname: Alonso
authors.forename: Clara
authors.initials: C
authors.lastname: Menéndez
mesh_terms: D000962:Antimalarials / Q000627:therapeutic use*; D004338:Drug Combinations; D005260:Female; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D016778:Malaria, Falciparum / Q000453:epidemiology* / Q000517:prevention & control*; D009017:Morbidity; D009073:Mozambique / Q000453:epidemiology; D010919:Placebos; D010920:Placenta / Q000469:parasitology; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic / Q000453:epidemiology* / Q000517:prevention & control*; D011256:Pregnancy Outcome / Q000453:epidemiology; D016016:Proportional Hazards Models; D011739:Pyrimethamine / Q000627:therapeutic use*; D012307:Risk Factors; D013413:Sulfadoxine / Q000627:therapeutic use*; D011795:Surveys and Questionnaires
chemical_list: D000962:Antimalarials; D004338:Drug Combinations; D010919:Placebos; C001205:fanasil, pyrimethamine drug combination; D013413:Sulfadoxine; D011739:Pyrimethamine