Author:
KALANDA B. F.,VERHOEFF F. H.,CHIMSUKU L.,HARPER G.,BRABIN B. J.
Abstract
To determine factors associated with fetal growth, preterm delivery and stillbirth in an area of high malaria transmission in Southern Malawi, a cross-sectional study of pregnant women attending and delivering at two study hospitals was undertaken. A total of 243 (17·3%) babies were preterm and 54 (3·7%) stillborn. Intra-uterine growth retardation (IUGR) occurred in 285 (20·3%), of whom 109 (38·2%) were low birthweight and 26 (9·1%) preterm. Factors associated with IUGR were maternal short stature [adjusted odds ratio (AOR) 1·6, 95% confidence interval (CI) 1·0–2·5]; primigravidae (AOR 1·9, 95% CI 1·4–2·7); placental or peripheral malaria at delivery (AOR 1·4, 95% CI 1·0–1·9) and maternal anaemia at recruitment (Hb <8 g/dl) (AOR 1·9, 95% CI 1·3–2·7). Increasing parasite density in the placenta was associated with both IUGR (P=0·008) and prematurity (P=0·02). Factors associated with disproportionate fetal growth were maternal malnutrition [mid-upper arm circumference (MUAC) <23 cm, AOR 1·9, 95% CI 1·0–3·7] and primigravidae (AOR 1·8, 95% CI 1·0–3·1). Preterm delivery and stillbirth were associated with <5 antenatal care visits (AOR 2·2, 95% CI 1·3–3·7 and AOR 3·1, 95% CI 1·4–7·0 respectively) and stillbirth with a positive Venereal Disease Research Laboratory (VDRL) test (AOR 4·7, 95% CI 1·5–14·8). Interventions to reduce poor pregnancy outcomes must reduce the burden of malaria in pregnancy, improve antenatal care and maternal malnutrition.
Publisher
Cambridge University Press (CUP)
Subject
Infectious Diseases,Epidemiology
Cited by
34 articles.
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