@article{fdi:010077096,
  title = {{E}ffects of malaria in the first trimester of pregnancy on poor maternal and birth outcomes in {B}enin},
  author = {{A}ccrombessi, {M}. and {Y}ovo, {E}. and {F}ievet, {N}adine and {C}ottrell, {G}illes and {A}gbota, {G}. and {G}artner, {A}gn{\`e}s and {M}artin-{P}r{\'e}vel, {Y}ves and {V}ianou, {B}. and {S}ossou, {D}. and {F}anou-{F}ogny, {N}. and {D}jossinou, {D}. and {M}assougbodji, {A}. and {C}ot, {M}ichel and {B}riand, {V}al{\'e}rie},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground. {I}n sub-{S}aharan {A}frica, malaria in the first half of pregnancy is harmful for both the mother and her fetus. {H}owever, malaria in the first trimester of pregnancy, when women are usually not protected against malaria, has been little investigated. {F}or the first time, we assessed the effects of malaria in the first trimester on maternal and birth outcomes using a preconceptional study design. {M}ethods. {F}rom {J}une 2014 to {M}arch 2017, 1214 women of reproductive age were recruited and followed monthly until 411 became pregnant. {T}he pregnant women were then followed from 5-6 weeks of gestation until delivery. {P}ath analysis was used to assess the direct effect (ie, not mediated by malaria in the second or third trimester) of malaria in the first trimester on maternal anemia and poor birth outcomes. {T}he cumulative effect of infections during pregnancy on the same outcomes was also evaluated. {R}esults. {T}he prevalence of malaria infections in the first trimester was 21.8%. {M}alaria in the first trimester was significantly associated with maternal anemia in the third trimester (adjusted odds ratio 2.25, 95% confidence interval 1.11-4.55). {W}hile we did not find evidence of any direct effect of first trimester malaria infections on birth outcomes, their association with infections later in pregnancy tended to increase the risk of low birth weights. {C}onclusions. {M}alaria infections in the first trimester were highly prevalent and have deleterious effects on maternal anemia. {T}hey highlight the need for additional preventive measures, starting in early pregnancy or even before conception.},
  keywords = {malaria infection ; first trimester ; poor maternal and birth outcomes ; preconceptional cohort ; {A}frica ; {BENIN}},
  booktitle = {},
  journal = {{C}linical {I}nfectious {D}iseases},
  volume = {69},
  numero = {8},
  pages = {1385--1393},
  ISSN = {1058-4838},
  year = {2019},
  DOI = {10.1093/cid/ciy1073},
  URL = {https://www.documentation.ird.fr/hor/fdi:010077096},
}