title: Plasmodium vivax Malaria in Pregnant Women in the Brazilian Amazon and the Risk Factors Associated with Prematurity and Low Birth Weight: A Descriptive Study.
abstract: BACKGROUND
  Plasmodium vivax is the most prevalent malaria species in the American region. Brazil accounts for the higher number of the malaria cases reported in pregnant women in the Americas. This study aims to describe the characteristics of pregnant women with malaria in an endemic area of the Brazilian Amazon and the risk factors associated with prematurity and low birth weight (LBW).
  
  
  RESULTS
  Between December 2005 and March 2008, 503 pregnant women with malaria that attended a tertiary health centre were enrolled and followed up until delivery and reported a total of 1016 malaria episodes. More than half of study women (54%) were between 20-29 years old, and almost a third were adolescents. The prevalence of anaemia at enrolment was 59%. Most women (286/503) reported more than one malaria episode and most malaria episodes (84.5%, 846/1001) were due to P. vivax infection. Among women with only P. vivax malaria, the risk of preterm birth and low birth weight decreased in multigravidae (OR, 0.36 [95% CI, 0.16-0.82]; p = 0.015 and OR 0.24 [95% CI, 0.10-0.58]; p = 0.001, respectively). The risk of preterm birth decreased with higher maternal age (OR 0.43 [95% CI, 0.19-0.95]; p = 0.037) and among those women who reported higher antenatal care (ANC) attendance (OR, 0.32 [95% CI, 0.15-0.70]; p = 0.005).
  
  
  CONCLUSIONS
  This study shows that P. vivax is the prevailing species among pregnant women with malaria in the region and shows that vivax clinical malaria may represent harmful consequences for the health of the mother and their offsprings particularly on specific groups such as adolescents, primigravidae and those women with lower ANC attendance.
authors.affiliation: Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil.|Universidade Federal do Amazonas, Manaus, Amazonas, Brazil.
authors.forename: Camila
authors.initials: C
authors.lastname: Bôtto-Menezes
authors.affiliation: Universidade Federal do Amazonas, Manaus, Amazonas, Brazil.
authors.forename: Mônica Caroline
authors.initials: MC
authors.lastname: Silva Dos Santos
authors.affiliation: Universidade Federal do Amazonas, Manaus, Amazonas, Brazil.
authors.forename: Janicéia
authors.initials: J
authors.lastname: Lopes Simplício
authors.affiliation: Universidade Federal do Amazonas, Manaus, Amazonas, Brazil.
authors.forename: Jandira
authors.initials: J
authors.lastname: Menezes de Medeiros
authors.affiliation: Universidade Federal do Amazonas, Manaus, Amazonas, Brazil.
authors.forename: Kelly Cristina
authors.initials: KC
authors.lastname: Barroso Gomes
authors.affiliation: Universidade Federal do Amazonas, Manaus, Amazonas, Brazil.
authors.forename: Isabel Cristina
authors.initials: IC
authors.lastname: de Carvalho Costa
authors.affiliation: Fundação de Medicina Tropical Dr. Heitor Vieira Dourado (FMT-HVD), Manaus, Amazonas, Brazil.
authors.forename: Eva
authors.initials: E
authors.lastname: Batista-Silva
authors.affiliation: Fundação de Medicina Tropical Dr. Heitor Vieira Dourado (FMT-HVD), Manaus, Amazonas, Brazil.
authors.forename: Cristiana
authors.initials: C
authors.lastname: Teixeira do Nascimento
authors.affiliation: Fundação de Medicina Tropical Dr. Heitor Vieira Dourado (FMT-HVD), Manaus, Amazonas, Brazil.
authors.forename: Eda Cristina
authors.initials: EC
authors.lastname: da Silva Chagas
authors.affiliation: Fundação de Medicina Tropical Dr. Heitor Vieira Dourado (FMT-HVD), Manaus, Amazonas, Brazil.
authors.forename: José Felipe
authors.initials: JF
authors.lastname: Jardim Sardinha
authors.affiliation: Universidade Federal do Amazonas, Manaus, Amazonas, Brazil.|Fundação de Medicina Tropical Dr. Heitor Vieira Dourado (FMT-HVD), Manaus, Amazonas, Brazil.
authors.forename: Franklin
authors.initials: F
authors.lastname: Simões de Santana Filho
authors.affiliation: Programa de Pós-Graduação em Medicina Tropical, Universidade do Estado do Amazonas, Manaus, Amazonas, Brazil.
authors.forename: Marianna
authors.initials: M
authors.lastname: Brock
authors.affiliation: ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain.
authors.forename: Azucena
authors.initials: A
authors.lastname: Bardají
authors.affiliation: Fundação de Medicina Tropical Dr. Heitor Vieira Dourado (FMT-HVD), Manaus, Amazonas, Brazil.|Centro de Pesquisas Leônidas e Maria Deane/Fiocruz Amazônia, Manaus, Amazonas, Brazil.
authors.forename: Flor Ernestina
authors.initials: FE
authors.lastname: Martínez-Espinosa
mesh_terms: D000293:Adolescent; D000328:Adult; D001724:Birth Weight; D001938:Brazil / Q000453:epidemiology; D002648:Child; D005260:Female; D005865:Gestational Age; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D016780:Malaria, Vivax / Q000453:epidemiology* / Q000469:parasitology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010966:Plasmodium vivax; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic / Q000453:epidemiology*; D012307:Risk Factors; D055815:Young Adult