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喀麦隆西南部地区孕妇、脐带血及胎盘疟原虫血症对新生儿出生体重的影响。

The effect of maternal, umbilical cord and placental malaria parasitaemia on the birthweight of newborns from South-western Cameroon.

作者信息

Akum Achidi E, Kuoh Anchang J, Minang Jacob T, Achimbom Boyo M, Ahmadou Mokube J, Troye-Blomberg Marita

机构信息

Faculty of Health Sciences, University of Buea, PO Box 63 Buea, Cameroon.

出版信息

Acta Paediatr. 2005 Jul;94(7):917-23. doi: 10.1111/j.1651-2227.2005.tb02011.x.

Abstract

AIM

The impact of maternal, umbilical cord and placental malaria parasitaemia on the incidence of low birthweight was investigated in pregnant women reporting for delivery at the Mutengene Maternity Centre, Fako Division, South West Province, Cameroon.

METHODS

The malaria parasitaemia status of 770 umbilical cords, parturient women and placental impression smears were determined by light microscopy using blood samples collected between June 1999 and September 2001. The birthweights (BW) of the newborns were recorded soon after delivery.

RESULTS

The results show that malaria parasites were present in the blood samples of 57 out of 730 (7.8%), 233/711 (32.8%) and 248/735 (33.7%) cord, maternal and placental biopsies respectively. Low birthweight (LBW) was recorded in 72 (9.6%) newborns, and the incidence was higher in primiparae. Newborns of mothers who had malaria parasites in their peripheral blood (12.4%) had a higher incidence (p=0.014) of LBW when compared with malaria parasite-free mothers (6.8%). Similarly, neonates born from malaria-positive placentas (13.5%) had a significantly higher incidence of LBW (p=0.006) than those from parasite-negative placentas (6.8%). Furthermore, newborns of malaria parasite-positive mothers, umbilical cords, placentas and primiparae had lower mean birthweight than malaria-negative mothers, placentas, umbilical cords and multiparae.

CONCLUSION

We suggest that parity and maternal and placental malaria parasitaemia at delivery have an important negative impact on birthweight, especially in first pregnancies. This observation emphasizes the need for appropriate aggressive intervention strategies such as the use of insecticide-treated bed nets or intermittent preventive treatment to control malaria in pregnancy in the study area.

摘要

目的

在喀麦隆西南省法科分区穆滕盖内妇产中心报告分娩的孕妇中,调查孕产妇、脐带和胎盘疟疾寄生虫血症对低出生体重发生率的影响。

方法

1999年6月至2001年9月期间采集的血液样本,通过光学显微镜确定770份脐带、产妇和胎盘压片涂片的疟疾寄生虫血症状态。新生儿出生体重(BW)在分娩后不久记录。

结果

结果显示,分别在730份脐带样本中的57份(7.8%)、711份产妇样本中的233份(32.8%)和735份胎盘活检样本中的248份(33.7%)血液样本中发现疟原虫。72名(9.6%)新生儿记录为低出生体重,初产妇中的发生率更高。外周血中有疟原虫的母亲所生新生儿(12.4%)的低出生体重发生率高于无疟原虫母亲所生新生儿(6.8%)(p=0.014)。同样,来自疟疾阳性胎盘的新生儿(13.5%)的低出生体重发生率显著高于来自疟原虫阴性胎盘的新生儿(6.8%)(p=0.006)。此外,疟疾寄生虫阳性母亲、脐带、胎盘和初产妇所生新生儿的平均出生体重低于疟疾阴性母亲、胎盘、脐带和经产妇所生新生儿。

结论

我们认为分娩时的产次以及孕产妇和胎盘疟疾寄生虫血症对出生体重有重要的负面影响,尤其是在初孕时。这一观察结果强调了在研究地区需要采取适当的积极干预策略,如使用经杀虫剂处理的蚊帐或间歇性预防治疗来控制孕期疟疾。

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