TY - JOUR
T1 - Malaria Infections and Placental Blood Flow
T2 - A Doppler Ultrasound Study from a Preconception Cohort in Benin
AU - Mondeilh, Aude
AU - Yovo, Emmanuel
AU - Accrombessi, Manfred
AU - Hounkonnou, Cornelia
AU - Agbota, Gino
AU - Atade, William
AU - Ladikpo, Olaiitan T.
AU - Mehoba, Murielle
AU - Degbe, Auguste
AU - Vianou, Bertin
AU - Sossou, Dariou
AU - Ndam, Nicaise Tuikue
AU - Massougbodji, Achille
AU - McGready, Rose
AU - Fievet, Nadine
AU - Rijken, Marcus J.
AU - Cottrell, Gilles
AU - Briand, Vale
N1 - Funding Information: Financial support. This work was supported by the Agence Nationale de la Recherche (Grant Number ANR-13-JSV1-0004) and the Fondation Simone Beer under the auspices of the Fondation de France (Grant Number 00074147). Publisher Copyright: © 2023 The Author(s). Published by Oxford University Press on behalf of Infectious Diseases Society of America.
PY - 2023/8/1
Y1 - 2023/8/1
N2 - Background: Malaria in pregnancy (MiP) has been associated with fetal growth restriction, the underlying pathogenic mechanisms of which remain poorly understood. Malaria in pregnancy is suspected to induce abnormalities in placental vascularization, leading to impaired placental development. Our study evaluated MIP's effect on uterine artery (UtA) and umbilical artery (UA) blood flow. Methods: The analysis included 253 Beninese women followed throughout pregnancy and screened monthly for submicroscopic and microscopic malaria. Uterine artery Doppler measurement was performed once between 21 and 25 weeks' gestation (wg), and UA Doppler measurement was performed 1-3 times from 28 wg. Linear and logistic regression models were used to assess the effect of malaria infections on UtA Doppler indicators (pulsatility index and presence of a notch), whereas a logistic mixed model was used to assess the association between malaria infections and abnormal UA Doppler (defined as Z-score ≥2 standard deviation or absent/reversed UA end-diastolic flow). Results: Primigravidae represented 7.5% of the study population; 42.3% of women had at least 1 microscopic infection during pregnancy, and 29.6% had at least 1 submicroscopic infection (and no microscopic infection). Both microscopic and submicroscopic infections before Doppler measurement were associated with the presence of a notch (adjusted odds ratio [aOR] 4.5, 95% confidence interval [CI] = 1.2-16.3 and aOR 3.3, 95% CI =. 9-11.9, respectively). No associations were found between malaria before the Doppler measurement and abnormal UA Doppler. Conclusions: Malaria infections in the first half of pregnancy impair placental blood flow. This highlights the need to prevent malaria from the very beginning of pregnancy.
AB - Background: Malaria in pregnancy (MiP) has been associated with fetal growth restriction, the underlying pathogenic mechanisms of which remain poorly understood. Malaria in pregnancy is suspected to induce abnormalities in placental vascularization, leading to impaired placental development. Our study evaluated MIP's effect on uterine artery (UtA) and umbilical artery (UA) blood flow. Methods: The analysis included 253 Beninese women followed throughout pregnancy and screened monthly for submicroscopic and microscopic malaria. Uterine artery Doppler measurement was performed once between 21 and 25 weeks' gestation (wg), and UA Doppler measurement was performed 1-3 times from 28 wg. Linear and logistic regression models were used to assess the effect of malaria infections on UtA Doppler indicators (pulsatility index and presence of a notch), whereas a logistic mixed model was used to assess the association between malaria infections and abnormal UA Doppler (defined as Z-score ≥2 standard deviation or absent/reversed UA end-diastolic flow). Results: Primigravidae represented 7.5% of the study population; 42.3% of women had at least 1 microscopic infection during pregnancy, and 29.6% had at least 1 submicroscopic infection (and no microscopic infection). Both microscopic and submicroscopic infections before Doppler measurement were associated with the presence of a notch (adjusted odds ratio [aOR] 4.5, 95% confidence interval [CI] = 1.2-16.3 and aOR 3.3, 95% CI =. 9-11.9, respectively). No associations were found between malaria before the Doppler measurement and abnormal UA Doppler. Conclusions: Malaria infections in the first half of pregnancy impair placental blood flow. This highlights the need to prevent malaria from the very beginning of pregnancy.
KW - Africa
KW - Doppler measurements
KW - malaria in pregnancy
KW - umbilical artery
KW - uterine artery
UR - http://www.scopus.com/inward/record.url?scp=85168778598&partnerID=8YFLogxK
U2 - https://doi.org/10.1093/ofid/ofad376
DO - https://doi.org/10.1093/ofid/ofad376
M3 - Article
C2 - 37577115
SN - 2328-8957
VL - 10
JO - Open forum infectious diseases
JF - Open forum infectious diseases
IS - 8
M1 - ofad376
ER -