Placental and neonatal outcome in maternal malaria.
OBJECTIVE
Primary: To determine the incidence of congenital malaria in a cohort of pregnant women in a hyper-endemic area of central India. Secondary: (1) To find out the placental weight and placental malaria positivity, and to assess fetal and neonatal outcome in terms of survival, mean hemoglobin and mean birth weight.


METHODS
Prospective observational study.


METHODS
Maternity and neonatal ward of a tertiary level hospital attached to a medical college located in Rewa, Madhya Pradesh, India.


METHODS
Near term and term pregnant women admitted in the maternity ward with a singleton pregnancy, whose neonates were available for examination till at least 6 hours after birth.


METHODS
Thick and thin blood smear were examined for malarial parasites from mothers prior to delivery. Based on the results of peripheral smear they were divided into 'exposed group' (peripheral smear positive for malaria parasite) and unexposed group' (smear negative for malaria parasite). These groups were then followed prospectively till delivery and subsequently till the mother and the neonates were discharged from the hospital.


METHODS
Primary: Presence of asexual parasite in neonate. Secondary: Placental weight, presence of asexual malarial parasite in placenta, still births, early neonatal deaths, mean birth weight and mean hemoglobin.


RESULTS
Seventy-two (35.5%) of 203 blood smears of near term and term pregnant women were found positive for malaria parasite (60 P. vivax and 12 P. falciparum); rest 131 comprised the unexposed group. Six (2.95%) neonates had parasitemia (4 P. vivax and 2 P. falciparum). Of the 203 smears made from placental blood, 24 (11.8%) were positive for malaria parasite. The mean (SD) birth weight [2300 (472) g vs 2430 (322) g; P=0.98], proportion of preterm babies (6.9% vs 8.4%, P=0.71), incidence of still birth (4.2% vs 3.0%, P=1.0) and early neonatal death (2.8% vs 3.0%, P=1.0) were not significantly different between the exposed and unexposed group.


CONCLUSIONS
The incidence of congenital malaria is low despite high maternal smear positivity for malaria.
Department of Pediatrics, Gandhi Memorial Hospital and Shyam Shah Medical College, Rewa, MP. India. Correspondence to: Dr HP Singh, Gandhi Memorial Hospital, and Shyam Shah Medical College, Rewa, MP. India. drhpsingh1@rediffmail.com.
Jyoti
J
Singh
Dharmendra
D
Soni
Devendra
D
Mishra
H P
HP
Singh
S
S
Bijesh
D000293:Adolescent; D000328:Adult; D001724:Birth Weight; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000469:parasitology; D008288:Malaria / Q000175:diagnosis / Q000453:epidemiology* / Q000469:parasitology; D018512:Parasitemia / Q000175:diagnosis / Q000453:epidemiology / Q000469:parasitology; D010920:Placenta / Q000469:parasitology*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis / Q000453:epidemiology* / Q000469:parasitology; D011446:Prospective Studies; D055815:Young Adult