Fetal growth and birth weight are independently reduced by malaria infection and curable sexually transmitted and reproductive tract infections in Kenya, Tanzania, and Malawi: A pregnancy cohort study
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Fetal growth and birth weight are independently reduced by malaria infection and curable sexually transmitted and reproductive tract infections in Kenya, Tanzania, and Malawi : A pregnancy cohort study. / Mtove, George; Chico, R Matthew; Madanitsa, Mwayiwawo; Barsosio, Hellen C; Msemo, Omari Abdul; Saidi, Queen; Gore-Langton, Georgia R; Minja, Daniel T R; Mukerebe, Crispin; Gesase, Samwel; Mwapasa, Victor; Phiri, Kamija S; Hansson, Helle; Dodd, James; Magnussen, Pascal; Kavishe, Reginald A; Mosha, Franklin; Kariuki, Simon; Lusingu, John P A; Gutman, Julie R; Alifrangis, Michael; Ter Kuile, Feiko O; Schmiegelow, Christentze.
In: International Journal of Infectious Diseases, Vol. 135, 2023, p. 28-40.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Fetal growth and birth weight are independently reduced by malaria infection and curable sexually transmitted and reproductive tract infections in Kenya, Tanzania, and Malawi
T2 - A pregnancy cohort study
AU - Mtove, George
AU - Chico, R Matthew
AU - Madanitsa, Mwayiwawo
AU - Barsosio, Hellen C
AU - Msemo, Omari Abdul
AU - Saidi, Queen
AU - Gore-Langton, Georgia R
AU - Minja, Daniel T R
AU - Mukerebe, Crispin
AU - Gesase, Samwel
AU - Mwapasa, Victor
AU - Phiri, Kamija S
AU - Hansson, Helle
AU - Dodd, James
AU - Magnussen, Pascal
AU - Kavishe, Reginald A
AU - Mosha, Franklin
AU - Kariuki, Simon
AU - Lusingu, John P A
AU - Gutman, Julie R
AU - Alifrangis, Michael
AU - Ter Kuile, Feiko O
AU - Schmiegelow, Christentze
N1 - Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.
PY - 2023
Y1 - 2023
N2 - OBJECTIVES: Malaria and sexually transmitted and reproductive tract infections (STIs/RTIs) are highly prevalent in sub-Saharan Africa and associated with poor pregnancy outcomes. We investigated the individual and combined effects of malaria and curable STIs/RTIs on fetal growth in Kenya, Tanzania, and Malawi.METHODS: This study was nested within a randomized trial comparing monthly intermittent preventive treatment for malaria in pregnancy with sulfadoxine-pyrimethamine vs dihydroartemisinin-piperaquine, alone or combined with azithromycin. Fetal weight gain was assessed by serial prenatal ultrasound. Malaria was assessed monthly, and Treponema pallidum, Neisseria gonorrhoeae, Trichomonas vaginalis, Chlamydia trachomatis, and bacterial vaginosis at enrollment and in the third trimester. The effect of malaria and STIs/RTIs on fetal weight/birthweight Z-scores was evaluated using mixed-effects linear regression.RESULTS: In total, 1435 pregnant women had fetal/birth weight assessed 3950 times. Compared to women without malaria or STIs/RTIs (n = 399), malaria-only (n = 267), STIs/RTIs only (n = 410) or both (n = 353) were associated with reduced fetal growth (adjusted mean difference in fetal/birth weight Z-score [95% confidence interval]: malaria = -0.18 [-0.31,-0.04], P = 0.01; STIs/RTIs = -0.14 [-0.26,-0.03], P = 0.01; both = -0.20 [-0.33,-0.07], P = 0.003). Paucigravidae experienced the greatest impact.CONCLUSION: Malaria and STIs/RTIs are associated with poor fetal growth especially among paucigravidae women with dual infections. Integrated antenatal interventions are needed to reduce the burden of both malaria and STIs/RTIs.
AB - OBJECTIVES: Malaria and sexually transmitted and reproductive tract infections (STIs/RTIs) are highly prevalent in sub-Saharan Africa and associated with poor pregnancy outcomes. We investigated the individual and combined effects of malaria and curable STIs/RTIs on fetal growth in Kenya, Tanzania, and Malawi.METHODS: This study was nested within a randomized trial comparing monthly intermittent preventive treatment for malaria in pregnancy with sulfadoxine-pyrimethamine vs dihydroartemisinin-piperaquine, alone or combined with azithromycin. Fetal weight gain was assessed by serial prenatal ultrasound. Malaria was assessed monthly, and Treponema pallidum, Neisseria gonorrhoeae, Trichomonas vaginalis, Chlamydia trachomatis, and bacterial vaginosis at enrollment and in the third trimester. The effect of malaria and STIs/RTIs on fetal weight/birthweight Z-scores was evaluated using mixed-effects linear regression.RESULTS: In total, 1435 pregnant women had fetal/birth weight assessed 3950 times. Compared to women without malaria or STIs/RTIs (n = 399), malaria-only (n = 267), STIs/RTIs only (n = 410) or both (n = 353) were associated with reduced fetal growth (adjusted mean difference in fetal/birth weight Z-score [95% confidence interval]: malaria = -0.18 [-0.31,-0.04], P = 0.01; STIs/RTIs = -0.14 [-0.26,-0.03], P = 0.01; both = -0.20 [-0.33,-0.07], P = 0.003). Paucigravidae experienced the greatest impact.CONCLUSION: Malaria and STIs/RTIs are associated with poor fetal growth especially among paucigravidae women with dual infections. Integrated antenatal interventions are needed to reduce the burden of both malaria and STIs/RTIs.
U2 - 10.1016/j.ijid.2023.07.012
DO - 10.1016/j.ijid.2023.07.012
M3 - Journal article
C2 - 37516425
VL - 135
SP - 28
EP - 40
JO - International Journal of Infectious Diseases
JF - International Journal of Infectious Diseases
SN - 1201-9712
ER -
ID: 367910659