| dc.description.abstract | Placental malaria contributes to maternal morbidity and low birth weight in malaria endemic countries. Intermittent anti‐malarial prophylaxis given twice during pregnancy has been shown to decrease the prevalence of low birth weight newborns. The goal of this study was to determine if uterine and umbilical blood flow is affected by maternal malaria and its growth consequences on the fetus.Pregnant women were recruited from Msambweni, Kenya, at the time of first antenatal visit. Patients with known medical disorders contributing to fetal growth restriction, placental dysfunction, and prematurity were excluded. Using a SonoSite 180 Plus ultrasound machine, the uterine and umbilical artery Doppler indices were studied in addition to fetal biometrics. Malaria infection was determined by PCR from maternal blood samples taken at the time of the first clinic visit and at delivery (maternal venous, placental‐intervillous, and cord blood). Newborn birth weight, length, and head circumference were measured. Study outcomes were stratified by 3 week gestational age groups and compared in malaria infected vs. not infected women.471 women were enrolled. Malaria infection prevalence was ∼7%. In 18–23 week gestational age groups, women with malaria had increased umbilical artery PI, RI and S/D ratios compared to women not infected with malaria. This effect was not seen in later gestational age groups. No difference in uterine artery Doppler indices was found between malaria infected and not infected women. Fetuses of malaria infected women had smaller BPD and HC compared to fetuses of not infected women (18–29 week gestational age groups). These fetal growth differences were not detected at birth.Antenatal malaria infection, especially at earlier gestational ages, affects umbilical blood flow and fetal head growth, a trend that does not continue in later pregnancy and following delivery. Malaria prophylaxis should be encouraged in all pregnant women as early as possible in pregnancy. | en_US |
