NIAID Now | March 17, 2020
Malaria remains a serious problem in sub-Saharan Africa, with young children and pregnant women at highest risk for sickness and death. Infection during pregnancy can affect the health of both the mother and fetus, causing problems such as severe anemia in the mother, pregnancy loss, premature birth, and low birthweight infants. To reduce the risk of malaria infection during pregnancy, women receive preventative drug treatments at their prenatal healthcare visits. However, the parasites that cause malaria have become resistant to these drugs, emphasizing the need for a vaccine to prevent malaria infection during pregnancy. However, before researchers can conduct a study testing a new malaria vaccine, they need to collect background information on pregnancy complications in women living in a region of Africa where malaria is prevalent. These baseline data can be used to compare outcomes associated with an experimental vaccine.
To study these baseline pregnancy outcomes, NIAID researchers and their colleagues in Mali followed more than 1,800 pregnant women receiving maternity care in Ouélessébougou, Mali, a region with high seasonal malaria transmission. They collected prenatal care and pregnancy outcome information using interviews, review of medical records, and physical examination of newborns. Two-hundred twenty-eight women contracted malaria during their pregnancy, with those in their first or second pregnancies more likely to be infected.
Researchers analyzed the relationship between adverse pregnancy outcomes and multiple factors such as the mother’s age, number of previous pregnancies, number of prenatal healthcare visits, and malaria prevention measures. The primary risk factors for stillbirth, early death of the newborn, and for premature birth were young age of the mother (less than 20 years old) and no previous pregnancies. Young maternal age also was associated with an increased risk of low birthweight of the baby. In contrast to findings from previous studies, the use of preventative malaria treatments in study participants did not reduce the odds of having a low-birthweight baby.
The information collected in this study can be used as a reference point for comparing adverse pregnancy outcomes in future malaria vaccine trials in pregnant women living in areas with high malaria transmission rates.
Reference: Andemel N et al. Adverse pregnancy outcomes among women presenting at antenatal clinics in Ouélessébougou, Mali. Reprod Health. 2020 Mar 17; 17(1):39.