Background
Methods
Study procedures
Laboratory methods
Clinical variables of interest
Statistical methods
Results
Study participants
Variable | Placental malaria status in pregnancy | ||
---|---|---|---|
No placental malaria (n = 127) | Placental malaria (n = 101) | p value | |
Maternal age, years | 22.7 (19.9–25.7) | 19.0 (17.9–21.3) | < 0.001 |
Primigravid | 23 (18.1) | 64 (63.4) | < 0.001 |
BMI, kg/m2 | 20.6 (19.0–22.2) | 21.0 (19.7–22.7) | 0.08 |
Twin gestationa | 0 (0.0) | 4 (4.0) | 0.04 |
GA at enrollment, weeks | 14.7 (13.6–15.9) | 15.3 (14.0–17.6) | 0.003 |
Household wealth index | 0.80 | ||
Lowest tertile | 46 (36.2) | 37 (36.6) | |
Middle tertile | 42 (33.1) | 37 (36.6) | |
Highest tertile | 39 (30.7) | 27 (26.7) | |
Intermittent preventive therapy drug | 0.01 | ||
Sulfadoxine-pyrimethamine | 40 (31.5) | 49 (48.5)s | |
Dihydroartemisinin-piperaquine | 87 (68.5) | 52 (51.5) | |
GA at delivery, weeks | 40.0 (39.0–40.9) | 39.3 (38.0–40.3) | < 0.001 |
Preterm birth < 37 weeks GA | 6 (4.7) | 15 (14.9) | 0.01 |
Very preterm birth < 32 weeks GA | 1 (0.8) | 4 (4.0) | 0.17 |
Low birth weightb | 10 (7.9) | 19 (18.8) | 0.01 |
Small for gestational agec | 19 (15.0) | 26 (25.7) | 0.04 |
Stillbirth | 0 (0.0) | 2 (2.0) | 0.09 |
Neonatal demised (N = 224) | 4 (3.2) | 0 (0.0) | 0.13 |
Longitudinal measures of P. falciparum infection
Variable | Placental malaria status in pregnancy | ||
---|---|---|---|
No placental malaria (n = 127) | Placental malaria (n = 101) | p value | |
Positive LAMP at enrollmenta | 84 (66.1) | 76 (75.3) | 0.14 |
Number of times parasitaemia detected per pregnancy | 2.0 (2.0–3.0) | 3.0 (2.0–5.0) | < 0.001 |
Any symptomatic malaria during pregnancy | 23 (18.1) | 30 (29.7) | 0.04 |
GA at first detection of symptomatic malaria, weeks | N = 23 18.3 (16.1–20.0) | N = 30 24.0 (18.9–28.3) | 0.01 |
GA at initial documented parasitaemia, weeks | 15.9 (14.3–17.9) | 16.1 (14.7–18.6) | 0.15 |
Variable | aOR | 95% CI | p value |
---|---|---|---|
Primigravidity | 9.06 | 4.39–18.71 | < 0.001 |
GA at enrollment, weeks | 1.24 | 1.02–1.50 | 0.03 |
Any symptomatic malaria during pregnancy | 1.88 | 0.82–4.32 | 0.14 |
GA of first documented infection, weeks | 1.06 | 0.97–1.16 | 0.19 |
Total number of times parasitaemia detected in pregnancy | 2.21 | 1.67–2.93 | < 0.001 |
Subgroup analyses
Variable | Primigravid (N = 87) | Multigravid (N = 141) | ||||
---|---|---|---|---|---|---|
aOR | 95% CI | p value | aOR | 95% CI | p value | |
GA at enrollment, weeks | 1.84 | 1.21–2.78 | < 0.01 | 1.12 | 0.88–1.44 | 0.36 |
Any symptomatic malaria in pregnancy | 0.57 | 0.14–2.38 | 0.44 | 2.89 | 1.05–7.95 | 0.04 |
GA of first documented infection, weeks | 0.82 | 0.67–1.01 | 0.06 | 1.12 | 1.02–1.24 | 0.02 |
Total number of times parasitaemia detected in pregnancy | 2.70 | 1.44–5.06 | < 0.01 | 2.30 | 1.65–3.23 | <0.001 |
Variable | Any symptomatic Malaria (N = 53) | Only asymptomatic parasitemia (N = 175) | ||||
---|---|---|---|---|---|---|
aOR | 95% CI | p value | aOR | 95% CI | p value | |
Primigravid | 2.63 | 0.54–12.76 | 0.23 | 12.07 | 5.24–27.81 | < 0.001 |
GA at enrollment, weeks | 1.36 | 0.89–2.08 | 0.15 | 1.26 | 1.00–1.58 | 0.05 |
GA of first documented infection, weeks | 1.13 | 0.99–1.23 | 0.07 | 1.01 | 0.90–1.13 | 0.83 |
Total number of times parasitemia detected in pregnancy | 2.43 | 1.37–4.30 | < 0.01 | 2.13 | 1.53–2.97 | < 0.001 |
Variable | < 14 weeks (N = 39) | 14–19.9 weeks (N = 148) | > = 20 weeks (N = 41) | ||||||
---|---|---|---|---|---|---|---|---|---|
aOR | 95% CI | p value | aOR | 95% CI | p value | aOR | 95% CI | p value | |
Primigravid | 29.30 | 3.95–217.5 | 0.001 | 10.63 | 4.12–27.42 | < 0.001 | 6.02 | 0.79–46.10 | 0.08 |
GA at enrollment, weeks | 0.78 | 0.14–4.33 | 0.78 | 1.58 | 1.19–2.09 | 0.002 | 1.14 | 0.77–1.67 | 0.51 |
Any symptomatic malaria in pregnancy | 1.44 | 0.12–16.71 | 0.77 | 1.92 | 0.67–5.52 | 0.23 | 9.90 | 0.96–102.48 | 0.06 |
Total number of times parasitaemia detected in pregnancy | 1.22 | 0.65–2.30 | 0.54 | 2.63 | 1.80–3.87 | < 0.001 | 5.61 | 1.59–19.78 | < 0.01 |