The authors have no commercial or other association that may pose a conflict of interest.
AM conceived the study, performed the statistical analysis and drafted the manuscript; ES and AJ carried out the immunological and molecular determinations; LQ participated in the statistical analysis; ERV, CD and AB participated in the interpretation of results and the drafting of the manuscript; BS participated in the acquisition of data; PLA and CM contributed to the interpretation of the results and the drafting of the manuscript. All authors have read and approved the manuscript.
The risk of Plasmodium falciparum malaria increases during pregnancy and at early postpartum. Immunological and physiological alterations associated with pregnancy that persist after delivery may contribute to the susceptibility to P. falciparum during early postpartum period.
To determine changes in antibody-mediated responses after pregnancy, levels of Immunoglobulin G (IgGs) specific for P. falciparum were compared in 200 pairs of plasmas collected from Mozambican women at delivery and during the first two months postpartum. IgGs against the surface of erythrocytes infected with a P. falciparum chondroitin sulphate A binding line (CS2) and a paediatric isolate (MOZ2) were measured by flow cytometry.
IgG levels against CS2 and MOZ2 were higher at postpartum than at delivery (p = 0.033 and p = 0.045, respectively) in women without P. falciparum infection. The analysis stratified by parity and period after delivery showed that this increase was significant in multi-gravid women (p = 0.023 for CS2 and p = 0.054 for MOZ2) and during the second month after delivery (p = 0.018 for CS2 and p = 0.015 for MOZ2).
These results support the view that early postpartum is a period of recovery from physiological or immunological changes associated with pregnancy.
Ramharter M, Grobusch MP, Kiessling G, Adegnika AA, Moller U, Agnandji ST, Kramer M, Schwarz N, Kun JF, Oyakhirome S, Issifou S, Borrmann S, Lell B, Mordmuller B, Kremsner PG: Clinical and parasitological characteristics of puerperal malaria. J Infect Dis. 2005, 191: 1005-1009. 10.1086/427781. CrossRefPubMed
Nguyen-Dinh P, Steketee RW, Greenberg AE, Wirima JJ, Mulenda O, Williams SB: Rapid spontaneous postpartum clearance ofPlasmodium falciparumparasitaemia in African women. Lancet. 1988, ii: 751-752. CrossRef
Aitken EH, Mbewe B, Luntamo M, Maleta K, Kulmala T, Friso MJ, Fowkes FJ, Beeson JG, Ashorn P, Rogerson SJ: Antibodies to chondroitin sulfate A-binding infected erythrocytes: dynamics and protection during pregnancy in women receiving intermittent preventive treatment. J Infect Dis. 2010, 201: 1316-1325. 10.1086/651578. CrossRefPubMed
Cox SE, Staalsoe T, Arthur P, Bulmer JN, Hviid L, Yeboah-Antwi K, Kirkwood BR, Riley EM: Rapid acquisition of isolate-specific antibodies to chondroitin sulfate A-adherentPlasmodium falciparumisolates in Ghanaian primigravidae. Infect Immun. 2005, 73: 2841-2847. 10.1128/IAI.73.5.2841-2847.2005. PubMedCentralCrossRefPubMed
Alonso P, Saute F, Aponte JJ, Gomez-Olive FX, Nhacolo A, Thomson R, Macete E, Abacassamo F, Ventura PJ, Bosch X, Menendez C, Dgedge M: Manhica DSS, Mozambique. Population, Health and Survival at INDEPTH Sites. 2001, 1: 189-195.
Menendez C, Bardaji A, Sigauque B, Romagosa C, Sanz S, Serra-Casas E, Macete E, Berenguera A, David C, Dobano C, Naniche D, Mayor A, Ordi J, Mandomando I, Aponte JJ, Mabunda S, Alonso PL: A randomized placebo-controlled trial of intermittent preventive treatment in pregnant women in the context of insecticide treated nets delivered through the antenatal clinic. PLoS One. 2008, 3: e1934-10.1371/journal.pone.0001934. PubMedCentralCrossRefPubMed
Alonso PL, Smith T, Schellenberg JR, Masanja H, Mwankusye S, Urassa H, Bastos De Azevedo I, Chongela J, Kobero S, Menendez C, Hurt N, Thomas MC, Lyimo E, Weiss NA, Hayes R, Kitua AY, Lopez MC, Kilama WL, Teuscher T, Tanner M: Randomised trial of efficacy of SPf66 vaccine againstPlasmodium falciparummalaria in children in southern Tanzania. Lancet. 1994, 344: 1175-1181. 10.1016/S0140-6736(94)90505-3. CrossRefPubMed
Serra-Casas E, Menendez C, Bardaji A, Quinto L, Dobano C, Sigauque B, Jimenez A, Mandomando I, Chauhan VS, Chitnis CE, Alonso PL, Mayor A: The effect of intermittent preventive treatment during pregnancy on malarial antibodies depends on HIV status and is not associated with poor delivery outcomes. J Infect Dis. 2010, 201: 123-131. 10.1086/648595. CrossRefPubMed
Serra-Casas E, Menendez C, Dobano C, Bardaji A, Quinto L, Ordi J, Sigauque B, Cistero P, Mandomando I, Alonso PL, Mayor A: Persistence ofPlasmodium falciparumparasites in infected pregnant Mozambican women after delivery. Infect Immun. 2011, 79: 298-304. 10.1128/IAI.00814-10. PubMedCentralCrossRefPubMed
Mayor A, Rovira-Vallbona E, Machevo S, Bassat Q, Aguilar R, Quinto L, Jimenez A, Sigauque B, Dobano C, Kumar S, Singh B, Gupta P, Chauhan VS, Chitnis CE, Alonso PL, Menendez C: Parity and placental infection affect antibody responses againstPlasmodium falciparumduring pregnancy. Infect Immun. 2011, 79: 1654-1659. 10.1128/IAI.01000-10. PubMedCentralCrossRefPubMed
Staalsoe T, Megnekou R, Fievet N, Ricke CH, Zornig HD, Leke R, Taylor DW, Deloron P, Hviid L: Acquisition and decay of antibodies to pregnancy-associated variant antigens on the surface ofPlasmodium falciparum-infected erythrocytes that protect against placental parasitemia. J Infect Dis. 2001, 184: 618-626. 10.1086/322809. CrossRefPubMed
Fievet N, Cot M, Ringwald P, Bickii J, Dubois B, Le Hesran JY, Migot F, Deloron P: Immune response toPlasmodium falciparumantigens in Cameroonian primigravidae: evolution after delivery and during second pregnancy. Clin Exp Immunol. 1997, 107: 462-467. 10.1046/j.1365-2249.1997.d01-966.x. PubMedCentralCrossRefPubMed
Pacsa AS: Impairment of immunity during pregnancy and antiviral effect of amniotic fluid. Lancet. 1977, i: 330-331. CrossRef
Zardi O, Poccia A: The behaviour of antitoxoplasmic antibodies during pregnancy. Biochem Exp Biol. 1980, 16: 295-299. PubMed
Amino N, Tanizawa O, Miyai K, Tanaka F, Hayashi C, Kawashima M, Ichihara K: Changes of serum immunoglobulins IgG, IgA, IgM, and IgE during pregnancy. Obstet Gynecol. 1978, 52: 415-420. PubMed
Skaug K, Ulstrup JC, Stray-Pedersen B: A rubella epidemic in an unvaccinated pregnant population. I. Screening methods and serological results. Scand J Infect Dis. 1981, 13: 11-15. PubMed
El-Roeiy A, Myers SA, Gleicher N: The prevalence of autoantibodies and lupus anticoagulant in healthy pregnant women. Obstet Gynecol. 1990, 75: 390-396. PubMed
- Immunoglobulins against the surface of Plasmodium falciparum- infected erythrocytes increase one month after delivery
Pedro L Alonso
- BioMed Central
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