@article{fdi:010060323,
  title = {{I}mpact of malaria during pregnancy on pregnancy outcomes in a {U}gandan prospective cohort with intensive malaria screening and prompt treatment},
  author = {{B}eaudrap, {P}ierre de and {T}uryakira, {E}. and {W}hite, {L}.{J}. and {N}abasumba, {C}. and {T}umwebaze, {B}. and {M}uehlenbachs, {A}. and {G}uerin, {P}.{J}. and {B}oum, {Y}. and {M}c{G}ready, {R}. and {P}iola, {P}.},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground: {M}alaria in pregnancy ({M}i{P}) is a major public health problem in endemic areas of sub-{S}aharan {A}frica and has important consequences on birth outcome. {B}ecause {M}i{P} is a complex phenomenon and malaria epidemiology is rapidly changing, additional evidence is still required to understand how best to control malaria. {T}his study followed a prospective cohort of pregnant women who had access to intensive malaria screening and prompt treatment to identify factors associated with increased risk of {M}i{P} and to analyse how various characteristics of {M}i{P} affect delivery outcomes. {M}ethods: {B}etween {O}ctober 2006 and {M}ay 2009, 1,218 pregnant women were enrolled in a prospective cohort. {A}fter an initial assessment, they were screened weekly for malaria. {A}t delivery, blood smears were obtained from the mother, placenta, cord and newborn. {M}ultivariate analyses were performed to analyse the association between mothers' characteristics and malaria risk, as well as between {M}i{P} and birth outcome, length and weight at birth. {T}his study is a secondary analysis of a trial registered with {C}linical{T}rials.gov, number {NCT}00495508. {R}esults: {O}verall, 288/1,069 (27%) mothers had 345 peripheral malaria infections. {T}he risk of peripheral malaria was higher in mothers who were younger, infected with {HIV}, had less education, lived in rural areas or reported no bed net use, whereas the risk of placental infection was associated with more frequent malaria infections and with infection during late pregnancy. {T}he risk of pre-term delivery and of miscarriage was increased in mothers infected with {HIV}, living in rural areas and with {M}i{P} occurring within two weeks of delivery. {I}n adjusted analysis, birth weight but not length was reduced in babies of mothers exposed to {M}i{P} (-60g, 95% {CI}: -120 to 0 for at least one infection and -150 g, 95% {CI}: -280 to -20 for > 1 infections). {C}onclusions: {I}n this study, the timing, parasitaemia level and number of peripherally-detected malaria infections, but not the presence of fever, were associated with adverse birth outcomes. {H}ence, prompt malaria detection and treatment should be offered to pregnant women regardless of symptoms or other preventive measures used during pregnancy, and with increased focus on mothers living in remote areas.},
  keywords = {{M}alaria in pregnancy ; {B}irth outcomes ; {S}ub-{S}aharan {A}frica ; {C}ohort ; {OUGANDA}},
  booktitle = {},
  journal = {{M}alaria {J}ournal},
  volume = {12},
  numero = {},
  pages = {139},
  ISSN = {1475-2875},
  year = {2013},
  DOI = {10.1186/1475-2875-12-139},
  URL = {https://www.documentation.ird.fr/hor/fdi:010060323},
}