Plasmodium vivax Malaria in Pregnant Women in the Brazilian Amazon and the Risk Factors Associated with Prematurity and Low Birth Weight: A Descriptive Study

PLoS One. 2015 Dec 16;10(12):e0144399. doi: 10.1371/journal.pone.0144399. eCollection 2015.

Abstract

Introduction: Plasmodium vivax is the most prevalent malaria species in the American region. Brazil accounts for the higher number of the malaria cases reported in pregnant women in the Americas. This study aims to describe the characteristics of pregnant women with malaria in an endemic area of the Brazilian Amazon and the risk factors associated with prematurity and low birth weight (LBW).

Methods/principal findings: Between December 2005 and March 2008, 503 pregnant women with malaria that attended a tertiary health centre were enrolled and followed up until delivery and reported a total of 1016 malaria episodes. More than half of study women (54%) were between 20-29 years old, and almost a third were adolescents. The prevalence of anaemia at enrolment was 59%. Most women (286/503) reported more than one malaria episode and most malaria episodes (84.5%, 846/1001) were due to P. vivax infection. Among women with only P. vivax malaria, the risk of preterm birth and low birth weight decreased in multigravidae (OR, 0.36 [95% CI, 0.16-0.82]; p = 0.015 and OR 0.24 [95% CI, 0.10-0.58]; p = 0.001, respectively). The risk of preterm birth decreased with higher maternal age (OR 0.43 [95% CI, 0.19-0.95]; p = 0.037) and among those women who reported higher antenatal care (ANC) attendance (OR, 0.32 [95% CI, 0.15-0.70]; p = 0.005).

Conclusion: This study shows that P. vivax is the prevailing species among pregnant women with malaria in the region and shows that vivax clinical malaria may represent harmful consequences for the health of the mother and their offsprings particularly on specific groups such as adolescents, primigravidae and those women with lower ANC attendance.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Birth Weight
  • Brazil / epidemiology
  • Child
  • Female
  • Gestational Age
  • Humans
  • Infant, Low Birth Weight*
  • Infant, Newborn
  • Infant, Premature*
  • Malaria, Vivax / epidemiology*
  • Malaria, Vivax / parasitology
  • Male
  • Middle Aged
  • Odds Ratio
  • Plasmodium vivax*
  • Pregnancy
  • Pregnancy Complications, Parasitic / epidemiology*
  • Risk Factors
  • Young Adult

Grants and funding

The study was supported by the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) and by the Fundação de Amparo à Pesquisa do Estado do Amazonas (FAPEAM), Regional Scientific Development Program (DCR/2005) conferred to FEME in 2005. AB received support from the European Union Seventh Framework Programme (FP7/2007-2013) under the grant agreement 201588.