Impact of Maternal Malaria and Under-Nutrition on Intrauterine Growth Restriction: A Prospective Ultrasound Study in Democratic Republic of Congo

Reference Type:
Journal Article

Secondary Title:

Series Title:

Author(s):
Landis, S. H.
Lokomba, V.
Ananth, Cande V.
Atibu, J.
Ryder, R. W.
Hartmann, Katherine E.
Thorp, John M., Jr.
Tshefu, A.
Meshnick, Steven R.

Editor(s):

Series Author(s):

Year Published:
2009

Date Published:

Journal Name:
Epidemiology and Infection

Volume Number:
137

Issue Number:
2

Start Page Number:
294-304

End Page Number:

Edition:

Series Volume:

Publisher:

City of Publication:

ISSN/ISBN:

DOI:
10.1017/S0950268808000915

PMCID:

NIHMSID:

Reference ID:
3468

Miscellaneous:

Abstract:

SUMMARYMaternal malaria and under-nutrition are established risk factors for small-for-gestational-age (SGA) births; however, whether malaria is associated with intrauterine growth restriction (IUGR) is unknown. We investigated IUGR risk among 177 HIV-negative pregnant women enrolled in a longitudinal ultrasound study conducted in Democratic Republic of Congo from May 2005 to May 2006. Malaria infection, maternal anthropometrics, and ultrasound estimated fetal weight were measured monthly. All positive malaria cases were treated and intermittent presumptive therapy (IPTp) provided. Log-binomial regression models for IUGR were fitted using generalized estimating equations to account for statistical clustering of repeat IUGR measurements. Twenty-nine percent of fetuses experienced an episode of IUGR with the majority occurring in the third trimester. The risk of IUGR associated with malaria was greatest after three or more cumulative infections (RR 3.3, 95% CI 1.3-8.2) and was two- to eight-fold higher among women with evidence of under-nutrition. Receiving antimalarial treatment in the previous month (for IPTp or treatment) was significantly protective against IUGR (RR 0.5, 95% CI 0.3-0.7). The interaction observed between malaria and under-nutrition suggests that antenatal programmes in malaria endemic areas should incorporate nutritional screening and supplementation in addition to IPTp.

Keyword(s):
Fertility, Families, and Children

URL:

http://dx.doi.org/10.1017/S0950268808000915

Notes:

RIS Export File:
Octet Stream icon

3468.ris — Octet Stream, 1 kB (1,998 bytes)

Citation:

Landis, S. H.; Lokomba, V.; Ananth, Cande V.; Atibu, J.; Ryder, R. W.; Hartmann, Katherine E.; Thorp, John M., Jr.; Tshefu, A.; & Meshnick, Steven R. (2009). Impact of Maternal Malaria and Under-Nutrition on Intrauterine Growth Restriction: A Prospective Ultrasound Study in Democratic Republic of Congo. Epidemiology and Infection, 137(2), 294-304.