title: OS025. Placental malaria infection as a risk factor for hypertensivedisorders of pregnancy in malaria endemic regions: A systematic review and meta-analysis.
abstract: Hypertensive disorders of pregnancy (HDP) are a leading cause of maternal mortality in low and middle income countries (LMICs). HDP complicates pregnancy in many malarial endemic areas with the greatest burden in sub-saharan Africa. It has been suggested that there is a link between placental malaria infection (PMI) caused by Plasmodium falciparum and HDP. To our knowledge, a systematic review has never been conducted on the relationship between PMI and HDP and the modification of that relationship with parity.
  
  
  
  1. To critically assess the association between PMI and HDP among a general obstetrical population in malarial endemic regions 2. To evaluate if the relationship between PMI and HDP is modified by parity.
  
  
  
  We conducted a systematic review for any study reporting on placental malaria and hypertension. A literature search based on a prospectively prepared protocol was conducted in PubMed Central and EMBASE until 06/09/2011. Additional data on parity of study participants in each study group was requested from corresponding authors of included studies by personal contact through email. Studies were assessed using the Newcastle-Ottawa Scale. The Cochrane Revman 5.1 software was used for statistical analysis according to standardised methodology. Risk Ratios with 95% confidence interval were calculated.
  
  
  
  Seven studies met our inclusion criteria [1-7]. These included cross-sectional, case control and observational studies. Six were in English and one was translated internally from French. One study [2] was further excluded because it did not represent a general obstetrical population. Our meta-analysis found no association between PMI and HDP in a general obstetric population in malaria endemic areas [RR of 1.00, 95% CI of 0.82,1.23]. Furthermore, we did not find that this relationship was modified by parity in two studies [RR (nulliparous) 0.92, 95% CI of 0.26,3.25)]. Events=women with HDP ().
  
  
  
  Although trends and associations have been reported in individual studies, we did not find a significant association between PMI and the risk of HDP. There is an apparent need for a large prospective cohort study to be conducted on PMI and the possible association with HDP.
authors.affiliation: Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, Canada.
authors.forename: B L
authors.initials: BL
authors.lastname: Bodkin
authors.affiliation: Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, Canada.
authors.forename: R
authors.initials: R
authors.lastname: Gordon
authors.affiliation: Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, Canada.
authors.forename: D
authors.initials: D
authors.lastname: Sawchuck
authors.affiliation: Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, Canada.
authors.forename: P
authors.initials: P
authors.lastname: von Dadelszen