Adverse Clinical and Obstetric Outcomes Associated with Placental Infection by Plasmodium falciparum in Luanda-Angola

Introduction: Placental malaria is a complication of malaria in pregnancy and is associated with adverse clinical and obstetric outcomes. This study intends to associate clinical symptoms of malaria and adverse obstetric outcomes with the presence of Plasmodium falciparum in the placenta of pregnant women in Luanda, Angola. Methods: We conducted a hospital based analytic cross-sectional study. Eight hundred and sixty-six women who were in labor and met the inclusion criteria were included in the study. The association between clinical and adverse obstetric outcomes and the presence of parasites in the placenta was analyzed using logistic regression. Results: P. falciparum (diagnosed by PCR) was detected in 143 (16.5%) women. Women who were primigravidae were at an increased risk to have placental malaria (OR = 1.5, CI 1.6 2.18). The presence of placental malaria increased the risk of postpartum hemorrhage (OR = 2.6, CI 1.09 6.24), premature rupture of membranes (OR = 1.5, CI 1.04 2.27) and low placental weight (OR = 1.8, CI 1.20 2.73). Placental malaria was significantly associated with gestations (p = 0.01), postpartum hemorrhage (p = 0.03), premature rupture of membranes (p = 0.01) and low placental weight (p = 0.003). Conclusions: Placental malaria due to P. falciparum infection was associated with a significant risk of adverse maternal and fetal outcomes in Luanda, Angola.