title: Effect of malaria in pregnancy on foetal cortical brain development: a longitudinal observational study.
abstract: BACKGROUND
  Malaria in pregnancy has a negative impact on foetal growth, but it is not known whether this also affects the foetal nervous system. The aim of this study was to examine the effects of malaria on foetal cortex development by three-dimensional ultrasound.
  
  
  METHODS
  Brain images were acquired using a portable ultrasound machine and a 3D ultrasound transducer. All recordings were analysed, blinded to clinical data, using the 4D view software package. The foetal supra-tentorial brain volume was determined and cortical development was qualitatively followed by scoring the appearance and development of six sulci. Multilevel analysis was used to study brain volume and cortical development in individual foetuses.
  
  
  RESULTS
  Cortical grading was possible in 161 out of 223 (72%) serial foetal brain images in pregnant women living in a malaria endemic area. There was no difference between foetal cortical development or brain volumes at any time in pregnancy between women with immediately treated malaria infections and non-infected pregnancies.
  
  
  CONCLUSIONS
  The percentage of images that could be graded was similar to other neuro-sonographic studies. Maternal malaria does not have a gross effect on foetal brain development, at least in this population, which had access to early detection and effective treatment of malaria.
authors: Shoklo Malaria Research Unit, PO Box 46, Mae Sot, Tak 63110, Thailand. marcus@shoklo-unit.com
authors: Marcus J
authors: MJ
authors: Rijken
authors: Merel Charlotte
authors: MC
authors: de Wit
authors: Eduard J H
authors: EJ
authors: Mulder
authors: Suporn
authors: S
authors: Kiricharoen
authors: Noaeni
authors: N
authors: Karunkonkowit
authors: Tamalar
authors: T
authors: Paw
authors: Gerard H A
authors: GH
authors: Visser
authors: Rose
authors: R
authors: McGready
authors: François H
authors: FH
authors: Nosten
authors: Lourens R
authors: LR
authors: Pistorius
mesh_terms: D000328:Adult; D002540:Cerebral Cortex / Q000000981:diagnostic imaging / Q000196:embryology*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D007231:Infant, Newborn; D008288:Malaria / Q000469:parasitology* / Q000473:pathology*; D008297:Male; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000469:parasitology* / Q000473:pathology*; D014463:Ultrasonography / Q000379:methods*; D055815:Young Adult