Department of Statistical Sciences, Faculty of Applied Science and Technology, Tamale Technical University, Tamale, Ghana
Department of Research Methodology and Data Analysis, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of).
BMJ Open. 2022 Aug 1;12(8):e058343. doi: 10.1136/bmjopen-2021-058343.
Malaria remains endemic in most of sub-Saharan Africa and has a negative impact among pregnant women, resulting in morbidity and poor birth outcomes. The purpose of this study was to assess the relationship between malaria and adverse birth outcomes among prenatal women in the Northern Region of Ghana.
This is a prospective cohort study of singleton pregnancies at 28 weeks of gestational age and above recruited between July 2018 and May 2019 from four public hospitals in the Northern Region of Ghana.
Low birth weight (LBW), preterm birth and perinatal death.
A total of 1323 pregnant women completed the study out of the 1626 recruited, with an average age of 27.3±5.2 years. The incidence of malaria in this population was 9.5% (95% CI 7.9 to 11.1). After adjusting for newborn admissions to the neonatal intensive care unit, parity, maternal age and glucose-6-phosphate dehydrogenase, women who were exposed to malaria during the third trimester of pregnancy had 2.02 times (95% CI 1.36 to 2.99) higher odds of premature delivery. Furthermore, they had 2.06 times (95% CI 1.09 to 3.93) higher chance of giving birth to babies with LBW, irrespective of their socioeconomic status. With an OR of 1.02 (95% CI 0.26 to 4.01), there was no difference in perinatal mortality between pregnant women with malaria and those without malaria after adjusting for caesarean section.
This study confirms that prenatal malaria increases the odds of both preterm and LBW deliveries. A decisive policy to eradicate or minimise perinatal malaria is needed to contribute to the prevention of LBW and adverse pregnancy outcomes.
疟疾在撒哈拉以南非洲的大部分地区仍然流行，对孕妇造成负面影响，导致发病率和不良分娩结局。本研究旨在评估加纳北部地区孕妇产前疟疾与不良分娩结局的关系。
这是一项前瞻性队列研究，纳入了 2018 年 7 月至 2019 年 5 月期间加纳北部地区 4 家公立医院招募的 28 周及以上的单胎妊娠孕妇。
低出生体重（LBW）、早产和围产儿死亡。
共有 1323 名孕妇完成了这项研究，而招募的 1626 名孕妇中只有 1323 名完成了研究，平均年龄为 27.3±5.2 岁。该人群的疟疾发病率为 9.5%（95%CI 7.9%至 11.1%）。在校正新生儿入住新生儿重症监护病房、产次、母亲年龄和葡萄糖-6-磷酸脱氢酶后，在妊娠晚期接触疟疾的孕妇早产的可能性增加 2.02 倍（95%CI 1.36 至 2.99）。此外，无论其社会经济地位如何，她们所生的 LBW 婴儿的几率增加了 2.06 倍（95%CI 1.09 至 3.93）。在校正剖宫产术后，疟疾孕妇与无疟疾孕妇的围产儿死亡率无差异，比值比为 1.02（95%CI 0.26 至 4.01）。
本研究证实产前疟疾增加了早产和 LBW 分娩的几率。需要采取果断的政策来消除或减少围产期疟疾，以预防 LBW 和不良妊娠结局。
