title: Complement activation, placental malaria infection, and birth weight in areas characterized by unstable malaria transmission in central Sudan.
abstract: BACKGROUND
  The pathogenesis of malaria during pregnancy is not completely understood. There are few published data on complement activation and malaria during pregnancy. This study aimed to investigate complement activation and malaria during pregnancy, and their association with hemoglobin and birth weight.
  
  
  METHODS
  A cross-sectional study was conducted at Medani, Sudan. Soluble terminal complement complex (TCC) levels were measured using ELISA in maternal and cord blood samples from 126 parturient women.
  
  
  RESULTS
  There were no Plasmodium falciparum-positive blood films from maternal peripheral blood, the placenta, or cord blood samples. Three (2.4%) and 22 (17.5%) of the placentas showed chronic and previous infection with histopathological examination, respectively, while 101 (80.2%) of them had no malaria infection. The mean [SD] of the maternal (22.4 [6.1] vs. 26.5 [3.5] ng/ml, P < 0.001) and cord blood (24.5 [4.5] vs. 26.8 [4.4] ng/ml, P = 0.024) TCC levels were significantly lower in cases of placental malaria infection (n = 25) than in those without placental malaria infection (n = 101). Linear regression showed that placental malaria infection was significantly associated with birth weight (-0.353 g, P = 0.013), but there were no associations between maternal and cord TCC levels and maternal hemoglobin, or between TCC levels and birth weight.
  
  
  CONCLUSIONS
  Maternal and cord blood TCC levels are lower in women with placental malaria infection than in those without placental malaria infection.
  The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/9600054761463915.
authors.affiliation: Faculty of Medical laboratory Sciences, University of Khartoum, Khartoum, Sudan. ammaralalim@gmail.com.
authors.forename: Ammar
authors.initials: A
authors.lastname: Alim
authors.affiliation: Faculty of Medical laboratory Sciences, University of Khartoum, Khartoum, Sudan. nasereldin2001@yahoo.com.
authors.forename: Naser
authors.initials: N
authors.lastname: E Bilal
authors.affiliation: Faculty of Medical laboratory Sciences, University of Khartoum, Khartoum, Sudan. awadko@hotmail.com.
authors.forename: Awad-Elkareem
authors.initials: AE
authors.lastname: Abass
authors.affiliation: Faculty of Medicine, University of Geziera, Medani, Sudan. elhasans@yahoo.com.
authors.forename: Elhassan M
authors.initials: EM
authors.lastname: Elhassan
authors.affiliation: Faculty of Medicine, Ribat University, Khartoum, Sudan. ahmedbadie60@yahoo.co.uk.
authors.forename: Ahmed A
authors.initials: AA
authors.lastname: Mohmmed
authors.affiliation: Faculty of Medicine, University of Khartoum, Khartoum, Sudan. ishagadam@hotmail.com.
authors.forename: Ishag
authors.initials: I
authors.lastname: Adam
mesh_terms: D015415:Biomarkers / Q000097:blood; D001724:Birth Weight; D003167:Complement Activation; D003430:Cross-Sectional Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005312:Fetal Blood / Q000276:immunology / Q000469:parasitology; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D016014:Linear Models; D016778:Malaria, Falciparum / Q000097:blood / Q000175:diagnosis / Q000276:immunology / Q000469:parasitology* / Q000635:transmission*; D015999:Multivariate Analysis; D016017:Odds Ratio; D010920:Placenta / Q000276:immunology / Q000469:parasitology*; D010963:Plasmodium falciparum / Q000276:immunology / Q000302:isolation & purification*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000097:blood / Q000175:diagnosis / Q000276:immunology / Q000469:parasitology*; D012307:Risk Factors; D013397:Sudan
chemical_list: D015415:Biomarkers; D006454:Hemoglobins