Placental Malaria Parasitization at Delivery: Experience at a Nigerian Tertiary Hospital

Background: In malaria endemic areas, pregnant women are constantly at risk of repeated malaria infestation which if left untreated, poses a significant threat to the health and survival of the mother and her baby. Objective: This study determined the prevalence and risk factors for placental malaria parasitaemia among parturients at the Federal Medical Centre, Yenagoa, Nigeria. Methodology: A prospective cross-sectional analytical study of 205 parturients recruited consecutively at presentation for delivery. An interviewer-administered questionnaire was used to collect data. After delivery, placental blood was collected for microscopy to detect malaria parasites. Data was analysed using SPSS version 22. Results: The prevalence of placental malaria parasitaemia was 13.7%. Maternal age <25 years (P<0.001), low educational status (P = 0.03), low parity (P = 0.03), unbooked status (P < 0.001) and non-use of intermittent preventive treatment (P <0.001) were significantly associated with placental malaria parasitaemia. Receiving three or more doses of sulphadoxine-pyrimethamine for intermittent preventive treatment of malaria in pregnancy was by far, more protective for placental malaria than receiving 2 doses (odds ratio = 0.25). Plasmodium falciparum was the only parasite species detected. Conclusion: Malaria still ravages our obstetric population and the significant contributors include low maternal age, low educational status, low parity, unbooked status and non-use of intermittent preventive treatment in pregnancy. Women should be encouraged to utilize antenatal care. There should be a prompt adoption of the recent WHO recommendations regarding malaria prophylaxis in pregnancy in all obstetric units and the medication should be given as Directly Observed Therapy

Correlation between placental malaria parasitaemia at delivery and infant birth weight in a Nigerian tertiary health centre

Background: Untreated malaria during pregnancy is detrimental to the health and survival of the mother, foetus and neonate due to its great potential to cause maternal anaemia, foetal death and intrauterine growth restriction leading to low birth weight. The foetal complications are due to impaired placental function that results from placental malaria parasitaemia as well as impaired foetal oxygenation from maternal anaemia. This study was conducted to determine the influence of placental malaria parasitaemia on infant birth weight.Methodology: This was a prospective cross-sectional analytical study of 205 parturients recruited consecutively as they presented for delivery at the Federal Medical Centre, Yenagoa. An interviewer-administered questionnaire was used to collect data. After delivery, the neonates were weighed and placental blood was collected for microscopy to detect malaria parasites. Data was analysed using SPSS version 22.Results: The prevalence of placental malaria parasitaemia was 13.7% and Plasmodium falciparum was the only parasite species detected. Placental malaria parasitaemia was associated with a reduction of the mean infant birth weight by 335 grams (P = 0.01).Conclusion: Malaria during pregnancy is still an important public health problem among our obstetric population, with a high prevalence of placental malaria parasitaemia and a significant negative effect on the birth weight of neonates. To enable the developing foetus achieve its full genetic growth potential, pregnant women should be encouraged to register early for antenatal care and utilize all the recommended malaria preventive measures.Keywords: Placenta, malaria infestation, birth weigh