Publications & Reports

Risk factors for malaria and adverse birth outcomes in a prospective cohort of pregnant women resident in a high malaria transmission area of Papua New Guinea.

Stanisic DI, Moore KA, Baiwog F, Ura A, Clapham C, King CL, Siba PM, Beeson JG, Mueller I, Fowkes FJ, Rogerson SJ
Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria 3050, Australia Institute of Glycomics, Griffith University, Southport, Queensland 4215, Australia.


BACKGROUND: Low birth weight (LBW), anaemia and malaria are common in Papua New Guinean (PNG) women. METHODS: To identify risk factors for LBW, anaemia and preterm delivery (PTD), pregnant women recruited into a cohort study in Madang, PNG were followed to delivery. RESULTS: Of 470 women enrolled, delivery data were available for 328 (69.7%). By microscopy, 34.4% (113/328) of women had malaria parasitaemia at enrolment and 12.5% (41/328) at delivery; at each time point, PCR detected sub-microscopic parasitaemia in substantially more. Most infections were with Plasmodium falciparum; the remainder being predominantly P. vivax. Anaemia and smoking were associated with lower birth weight, and LBW (16.7%; 51/305) and PTD (21.8%; 63/290) were common. Histopathologically-diagnosed chronic placental malaria was associated with LBW (adjusted odds ratio [aOR] 3.3; p=0.048) and PTD (aOR 4.2; p=0.01). Lack of maternal education predisposed to PTD. Sub-microscopic parasitaemia at delivery appeared to increase risk of LBW. Of the genetic polymorphisms Southeast Asian ovalocytosis, alpha+-thalassaemia and complement receptor 1 (CR1) deficiency, a CR1 heterozygous genotype was associated with decreased risk of anaemia, and substantial, but non-significant, effects were noted in other comparisons. CONCLUSIONS: In coastal PNG, malaria and anaemia are important causes of adverse pregnancy outcomes.

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  • Journal: Transactions of the Royal Society of Tropical Medicine and Hygiene
  • Published: 10/03/2015
  • Volume: 109
  • Issue: 5
  • Pagination: 313-324