In utero exposure to malaria is associated with metabolic traits in adolescence: The Agogo 2000 birth cohort study

J Infect. 2017 Nov;75(5):455-463. doi: 10.1016/j.jinf.2017.08.010. Epub 2017 Aug 26.

Abstract

Objectives: Malaria in pregnancy (MiP) contributes to fetal undernutrition and adverse birth outcomes, and may constitute a developmental origin of metabolic diseases in the offspring. In a Ghanaian birth cohort, we examined the relationships between MiP-exposure and metabolic traits in adolescence.

Methods: MiP at delivery was assessed in 155 mother-child pairs. Among the now teenaged children (mean age, 14.8 years; 53% male), we measured fasting plasma glucose (FPG), body mass index (BMI), and systolic and diastolic blood pressure (BP). Associations of MiP with the adolescents' FPG, BMI, and BP were examined by linear regression.

Results: At delivery, 45% were MiP-exposed, which increased FPG in adolescence, adjusted for mother's age at delivery, parity and familial socio-economic status (infected vs. uninfected: mean ΔFPG = 0.20 mmol/L; 95% confidence interval (CI): 0.01, 0.39; p = 0.049). As a trend,this was discernible for BP, particularly for microscopic infections (mean Δsystolic BP = 5.43 mmHg; 95% CI: 0.00, 10.88; p = 0.050; mean Δdiastolic BP = 3.67 mmHg; 95% CI: -0.81, 8.14; p = 0.107). These associations were largely independent of birth weight, gestational age and teenage BMI. Adolescent BMI was not related to MiP.

Conclusions: In rural Ghana, exposure to malaria during fetal development contributes to metabolic conditions in young adulthood.

Keywords: Ghana; Hypertension; Malaria in pregnancy; Obesity; Type 2 diabetes.

MeSH terms

  • Adolescent
  • Adult
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Ghana
  • Humans
  • Infant, Newborn
  • Malaria / embryology*
  • Malaria / metabolism
  • Male
  • Maternal Exposure
  • Metabolism, Inborn Errors / etiology*
  • Pregnancy
  • Pregnancy Complications, Infectious*
  • Pregnancy Outcome
  • Prenatal Exposure Delayed Effects