Caroline Shulman|Tom Marshall|E. B. Dorman|Judith N. Bulmer|Felicity Cutts|Norbert Peshu|Kevin Marsh
Malaria in pregnancy: adverse effects on haemoglobin levels and birthweight in primigravidae and multigravidae
London School of Hygiene & Tropical Medicine|London School of Hygiene & Tropical Medicine|Homerton University Hospital|Royal Victoria Infirmary|London School of Hygiene & Tropical Medicine|Kenya Medical Research Institute|Kenya Medical Research Institute|University of Oxford
background areas endemic transmission malaria pregnancy associated severe maternal anaemia low birthweight babies prevalence infection highest primigravidae pg hence control efforts usually geared towards high risk group using sensitive measure placental infection investigated relationship activeacute activechronic past placental infection maternal anaemia low birthweight women gravidities methods january 1996 july 1997 912 women delivering kilifi district hospital kenya recruited haemoglobin peripheral malaria slides taken prior delivery placental biopsies smears taken time delivery birthweight maternal height weight measured soon birth information obtained socioeconomic educational status association placental malaria severe anaemia low birthweight investigated women different gravidities findings placental histology prevalence active past malaria gravidities high ranging 64 pg 30 gravidities 5 gravidities 14 active malaria infection associated severe maternal anaemia adjusted 221 95 ci 136 361 significant interaction chronic past malaria severe anaemia effects birthweight whereby risk low birthweight high women chronic past placental malaria severe anaemia 453 119 172 pg 135 457 40 gravidities 24 interpretation area moderate malaria transmission women parities substantially increased risk low birthweight severe anaemia result malaria infection pregnancy risk low birthweight likely particularly high areas high prevalence severe anaemia