@article{fdi:010064199,
  title = {{S}ubmicroscopic {P}lasmodium falciparum infections are associated with maternal anemia, premature births, and low birth weight},
  author = {{C}ottrell, {G}illes and {M}oussiliou, {A}. and {L}uty, {A}drian and {C}ot, {M}ichel and {F}ievet, {N}adine and {M}assougbodji, {A}. and {D}eloron, {P}hilippe and {T}uikue {N}dam, {N}icaise},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground. {M}olecular, as opposed to microscopic, detection measures the real prevalence of {P}lasmodium falciparum infections. {S}uch occult infections are common during pregnancy but their impact on pregnancy outcomes is unclear. {W}e performed a longitudinal study to describe that impact. {M}ethods. {I}n a cohort of 1037 {B}eninese pregnant women, we used ultrasound to accurately estimate gestational ages. {I}nfection with {P}. falciparum, hemoglobin concentration, use of intermittent preventive treatment during pregnancy ({IPT}p) for malaria, and other parameters were recorded during pregnancy. {U}sing multivariate analyses, we evaluated the impact of submicroscopic infections on maternal anemia, premature birth, and low birth weight. {R}esults. {A}t inclusion, polymerase chain reaction ({PCR}) and microscopy detected infection in 40% and 16% of women, respectively. {T}he proportion infected declined markedly after 2 doses of {IPT}p but rebounded to 34% (by {PCR}) at delivery. {S}ubmicroscopic infections during pregnancy were associated with lower mean hemoglobin irrespective of gravidity, and with increased anemia risk in primigravidae (odds ratio [{OR}], 2.23; 95% confidence interval [{CI}], .98-5.07). {P}rospectively, submicroscopic infections at inclusion were associated with significantly increased risks of low birth weight in primigravidae ({OR}, 6.09; 95% {CI}, 1.16-31.95) and premature births in multigravidae ({OR}, 2.25; 95% {CI}, 1.13-4.46). {C}onclusions. {I}n this detailed longitudinal study, we document the deleterious impact of submicroscopic {P}. falciparum parasitemia during pregnancy on multiple pregnancy outcomes. {P}arasitemia occurs frequently during pregnancy, but routine microscopic and rapid diagnostic tests fail to detect the vast majority of episodes. {O}ur findings imply caution in any revision of the current strategies for prevention of pregnancy-associated malaria.},
  keywords = {malaria ; {PCR} ; submicroscopic ; pregnancy ; {P}lasmodium falciparum ; {BENIN}},
  booktitle = {},
  journal = {{C}linical {I}nfectious {D}iseases},
  volume = {60},
  numero = {10},
  pages = {1481--1488},
  ISSN = {1058-4838},
  year = {2015},
  DOI = {10.1093/cid/civ122},
  URL = {https://www.documentation.ird.fr/hor/fdi:010064199},
}