Mothers, Babies and Women's Health Program, Mater Research Institute, Faculty of Medicine, The University of Queensland, South Brisbane, QLD, Australia.
Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Int J Infect Dis. 2019 Jul;84:54-65. doi: 10.1016/j.ijid.2019.04.019. Epub 2019 Apr 24.
A novel conceptual framework to describe the relationship between placental malaria and adverse infant neurodevelopmental outcomes is proposed. This conceptual framework includes three distinct stages: (1) maternal and environmental risk factors for the development of placental malaria; (2) placental pathology and inflammation associated with placental malaria infection; and (3) postnatal impacts of placental malaria. The direct, indirect, and bidirectional effects of these risk factors on infant neurodevelopment across the three stages were critically examined. These factors ultimately culminate in an infant phenotype that not only leads to adverse birth outcomes, but also to increased risks of neurological, cognitive, and behavioural deficits that may impact the quality of life in this high-risk population. Multiple risk factors were identified in this conceptual framework; nonetheless, based on current evidence, a key knowledge gap is the uncertainty regarding which are the most important and how exactly they interact.
提出了一个新的概念框架来描述胎盘疟疾与不良婴儿神经发育结果之间的关系。该概念框架包括三个不同阶段：（1）胎盘疟疾发展的母体和环境危险因素；（2）与胎盘疟疾感染相关的胎盘病理和炎症；（3）胎盘疟疾的产后影响。批判性地检查了这些危险因素在三个阶段对婴儿神经发育的直接、间接和双向影响。这些因素最终导致婴儿表现出不仅导致不良出生结局，而且增加神经、认知和行为缺陷风险的表型，这可能会影响这一高风险人群的生活质量。在这个概念框架中确定了多个危险因素；然而，根据现有证据，一个关键的知识差距是不确定哪些因素最重要，以及它们如何确切地相互作用。
