Impact of pregnancy-associated malaria on infant malaria infection in southern Benin.
BACKGROUND
Infants of mothers with placental Plasmodium falciparum infections at delivery are themselves more susceptible to malaria attacks or to infection in early life.


RESULTS
To assess the impact of either the timing or the number of pregnancy-associated malaria (PAM) infections on the incidence of parasitemia or malaria attacks in infancy, we followed 218 mothers through pregnancy (monthly visits) up to delivery and their infants from birth to 12 months of age (fortnightly visits), collecting detailed clinical and parasitological data. After adjustment on location, mother's age, birth season, bed net use, and placental malaria, infants born to a mother with PAM during the third trimester of pregnancy had a significantly increased risk of infection (OR [95% CI]: 4.2 [1.6; 10.5], p = 0.003) or of malaria attack (4.6 [1.7; 12.5], p = 0.003). PAM during the first and second trimesters had no such impact. Similarly significant results were found for the effect of the overall number of PAM episodes on the time to first parasitemia and first malaria attack (HR [95% CI]: 2.95 [1.58; 5.50], p = 0.001 and 3.19 [1.59; 6.38], p = 0.001) respectively.


CONCLUSIONS
This study highlights the importance of protecting newborns by preventing repeated episodes of PAM in their mothers.
Centre d'étude et de recherche sur le paludisme associé à la grossesse et à l'enfance (CERPAGE), Faculté des Sciences de la Santé, Université d'Abomey-Calavi, Cotonou, Benin ; Institut de Recherche pour le Développement, UMR 216, Mère et enfant face aux infections tropicales, Paris, France ; PRES Sorbonne Paris Cité, Université Paris Descartes, Faculté de Pharmacie, Paris, France.
Sophie
S
Borgella
Nadine
N
Fievet
Bich-Tram
BT
Huynh
Samad
S
Ibitokou
Gbetognon
G
Hounguevou
Jacqueline
J
Affedjou
Jean-Claude
JC
Sagbo
Parfait
P
Houngbegnon
Blaise
B
Guezo-Mévo
Achille
A
Massougbodji
Adrian J F
AJ
Luty
Michel
M
Cot
Philippe
P
Deloron
D001541:Benin / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D016778:Malaria, Falciparum / Q000453:epidemiology* / Q000635:transmission*; D018512:Parasitemia / Q000453:epidemiology / Q000635:transmission; D010920:Placenta / Q000469:parasitology; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic; D012307:Risk Factors