@article{fdi:010058234,
  title = {{M}alaria and gravidity interact to modify maternal haemoglobin concentrations during pregnancy},
  author = {{O}uedraogo, {S}. and {B}odeau-{L}ivinec, {F}. and {B}riand, {V}al{\'e}rie and {H}uynh, {B}. {T}. and {K}oura, {G}. {K}. and {A}ccrombessi, {M}. {M}. {K}. and {F}ievet, {N}adine and {M}assougbodji, {A}. and {D}eloron, {P}hilippe and {C}ot, {M}ichel},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground: {P}rimigravidity is one of the main risk factors for both malaria and anaemia. {S}ince the implementation of intermittent preventive treatment ({IPT}p) in sub-{S}aharan {A}frica, the relationship between anaemia and gravidity and its evolution during pregnancy has been little explored. {T}his study aimed to evaluate the impact of gravidity on the variation of haemoglobin during pregnancy according to the timing of gestation. {M}ethods: {D}ata from three studies carried out in nearby areas in south {B}enin ({O}uidah, {C}ome, {A}llada) between 2005 and 2012 were analysed. {A}t inclusion (first antenatal visit, {ANV}1) women's age, area of residence, schooling, gravidity, gestational age, weight and height were recorded. {T}hick blood smears were performed on {ANV}1, second visit ({ANV}2) and at delivery. {I}n {A}llada, women's serum ferritin and {CRP} concentrations were also assessed. {T}he impact of gravidity on maternal haemoglobin ({H}b) was analysed using a logistic or linear regression depending on the outcome. {T}he statistical significance was set to {P} < 0.05. {R}esults: {I}n total, data from 3,591 pregnant women were analysed. {B}oth univariate and multivariate analyses showed a constant association between {H}b concentrations and gravidity in the three periods of {H}b assessment ({ANV}1, {ANV}2 and delivery). {M}ean {H}b concentration was significantly lower in primigravidae than in multigravidae at {ANV}1 (mean difference = -2.4 g/{L}, {CI} 95%: [-3.4, -1.4], {P} < 0.001). {A}fterwards, there was a significant increase in primigravidae only, with a tendency to reversal between primigravidae and multigravidae, which was confirmed at delivery (mean difference = 2.8 g/{L}, {CI} 95%: [1.3, 4.2], {P} < 0.001). {T}he prevalence of malaria infection was halved between {ANV}1 and delivery in primigravidae while it decreased by only 38% among multigravidae, who were less prone to malaria infection (prevalence at {ANV}1, 20% and 10% respectively). {I}ron deficiency was more common in multigravidae, and it decreased slightly in this group between {ANV}1 and delivery. {C}onclusion: {I}n a context of {IPT}p, {H}b levels improved progressively throughout pregnancy in primigravidae, likely as a result of reduction in malaria infection. {I}n multigravidae, the improvement was less perceptible and anaemia was mainly due to iron deficiency.},
  keywords = {{A}naemia ; {G}ravidity ; {M}alaria ; {I}ron deficiency ; {P}revention ; {BENIN}},
  booktitle = {},
  journal = {{M}alaria {J}ournal},
  volume = {11},
  numero = {},
  pages = {348},
  ISSN = {1475-2875},
  year = {2012},
  DOI = {10.1186/1475-2875-11-348},
  URL = {https://www.documentation.ird.fr/hor/fdi:010058234},
}