Placental malaria prevalence of infestation amongst febrile pregnant women in central India: maternal and perinatal outcome.

OBJECTIVE

To determine the prevalence and impact of placental malaria on maternal and fetal outcome.

DESIGN

Cross sectional observational.

SETTING

The Department of Obstetrics of Government NSCB Medical College Hospital, Jabalpur (Madhya Pradesh).

POPULATION

Five hundred parturient women with fever or history of fever during the present pregnancy.

METHOD(S): Subjects were tested for peripheral and placental malaria by thick and thin smear examination. Maternal and perinatal outcome correlated with malaria results.

RESULTS(S): The mean age of the studied subjects was 24.5 ± 2.6 years, 60.6 % were primigravida, 87.2 % had unsatisfactory antenatal care. 89.2 % were not using effective malaria prevention measures. Peripheral smear positivity for malaria was detected in 1.8 % subjects and placental malaria positivity in 2.2 % subjects. The mean Hb was lower in malaric subjects (χ(2) = 14.47, p < 0.05). Maternal mortality and prematurity was significantly higher in malaria +ve subjects (p < 0.001). The mean birth weight in malaria +ve subjects was significantly less (p < 0.001). Poor 5 min APGAR (p < 0.0001) and perinatal mortality (p < 0.05) was significantly more common in malaria +ve subjects.

CONCLUSION(S): Malaria, particularly placental infestation with malarial parasites significantly increases maternal and perinatal morbidity and mortality.