Effects of malaria in pregnancy on newborn anthropometry.

BACKGROUND Malaria in pregnancy remains a major cause of infant mortality through its contribution to preterm delivery, low birth weight and intrauterine death. METHODOLOGY During a cross-sectional study of 983 mothers delivering in a secondary health care facility in Ibadan, southwestern Nigeria, an area of high malaria transmission, the effect of maternal and placental malaria parasitaemia on newborn anthropometry was evaluated. Malaria parasitemia was detected by microscopy of Giemsa stained thick blood smears. RESULTS Placental, maternal and combined placental and maternal malaria parasitaemia rates at the time of delivery were 13.1%, 12.7% and 11.1% respectively. The geometric mean parasite densities in maternal and placental smears were significantly higher in primigravid mothers than others (p = 0.004 and 0.002 respectively). Low birth weight rate was higher among babies born to mothers with maternal parasitaemia compared to those without (8.0 % versus 6.3%, p < 0.05). The mean birth weight was lower in neonates of mothers with peripheral and placental parasitaemia by 138 g and 122 g (p = 0.01 and 0.02) respectively, while the respective difference was up to 168 g and 151 g among primigravidae (p = 0.03 and 0.04). Neonates of mothers with maternal and placental parasitaemia had a lower mean length than those without parasitaemia (48.2 vs 49.2cm, p = < 0.0001 and 48.5 vs 49.2cm p = 0.02 respectively). Occiptofrontal circumference and ponderal indices were not significantly affected by maternal malaria parasitaemia. CONCLUSION Malaria in pregnancy results in symmetric foetal growth restriction and the effect is more marked among primigravid mothers.