Lehner P J, Andrews C J
Papua New Guinea Institute of Medical Research, Madang.
Trans R Soc Trop Med Hyg. 1988;82(6):822-6. doi: 10.1016/0035-9203(88)90006-5.
The incidence of malarial infection in pregnant women at delivery, their corresponding infants and umbilical cords and a control group of non-pregnant women were investigated in the Madang region of Papua New Guinea. Anti-malarial antibody titres were measured in maternal and paired cord sera. Parasitaemia occurred in 18/73 (24.7%) of non-pregnant females compared with 15/51 (29.4%) of pregnant females. Malarial parasites were found in 7/48 (14.6%) cord blood samples and in 4/52 (7.7%) samples of the infant's peripheral blood, indicating transplacental transmission. Infection with Plasmodium falciparum was commoner in pregnant than non-pregnant females, and accounted for all the cord and infant infections. A significant correlation was found between anti-malarial IgG antibodies in paired maternal and cord bloods. There was an association between umbilical cord infection and low levels of cord antibody. Clinical malaria developed in at least one out of the 7 cases in which placental transfer of parasites was known to have occurred. This study suggests that transfer of parasites across the placenta is a common event in Papua New Guinea. Further consideration should be given to treatment with anti-malarial drugs of infants with cord or peripheral blood parasitaemia or, indeed, of all infants of mothers with parasitaemia.
在巴布亚新几内亚的马当地区，对分娩时的孕妇、其相应的婴儿和脐带以及一组非孕妇对照组进行了疟疾感染发生率的调查。检测了母体和配对脐带血清中的抗疟抗体滴度。非孕妇中有18/73（24.7%）出现寄生虫血症，而孕妇中有15/51（29.4%）出现寄生虫血症。在48份脐带血样本中有7份（14.6%）发现疟原虫，在52份婴儿外周血样本中有4份（7.7%）发现疟原虫，表明存在经胎盘传播。恶性疟原虫感染在孕妇中比非孕妇更常见，并且所有脐带和婴儿感染均由其引起。在配对的母体和脐带血中发现抗疟IgG抗体之间存在显著相关性。脐带感染与脐带抗体水平低之间存在关联。在已知发生寄生虫胎盘转移的7例病例中，至少有1例出现了临床疟疾。这项研究表明，在巴布亚新几内亚，寄生虫经胎盘转移是一个常见事件。对于脐带血或外周血有寄生虫血症的婴儿，或者实际上对于有寄生虫血症母亲的所有婴儿，应进一步考虑使用抗疟药物进行治疗。
