Department of Obstetrics and Gynecology, University of Nairobi, Nairobi, Kenya.
Kenyatta National Hospital, Nairobi, Kenya.
PLoS One. 2023 Oct 19;18(10):e0291172. doi: 10.1371/journal.pone.0291172. eCollection 2023.
Malaria and preeclampsia are leading causes of maternal morbidity and mortality in sub-Saharan Africa. They contribute significantly to poor perinatal outcomes like low neonatal weight by causing considerable placental morphological changes that impair placental function. Previous studies have described the effects of either condition on the placental structure but the structure of the placenta in malaria-preeclampsia comorbidity is largely understudied despite its high burden. This study aimed to compare the placental characteristics and neonatal weights among women with malaria-preeclampsia comorbidity versus those with healthy pregnancies.
We conducted a retrospective cohort study among 24 women with malaria-preeclampsia comorbidity and 24 women with healthy pregnancies at a County Hospital in Western Kenya. Neonatal weights, gross and histo-morphometric placental characteristics were compared among the two groups.
There was a significant reduction in neonatal weights (P<0.001), placental weights (P = 0.028), cord length (P<0.001), and cord diameter (P<0.001) among women with malaria-preeclampsia comorbidity compared to those with healthy pregnancies. There was also a significant reduction in villous maturity (P = 0.016) and villous volume density (P = 0.012) with increased villous vascularity (P<0.007) among women with malaria-preeclampsia comorbidity compared to those with healthy pregnancies.
Placental villous maturity and villous volume density are significantly reduced in patients with malaria-preeclampsia comorbidity with a compensatory increase in villous vascularity. This leads to impaired placental function that contributes to lower neonatal weights.
疟疾和子痫前期是撒哈拉以南非洲产妇发病率和死亡率的主要原因。它们通过引起相当大的胎盘形态变化，损害胎盘功能，对围产期结局产生重大影响，如新生儿体重低。先前的研究描述了这两种情况对胎盘结构的影响，但疟疾-子痫前期合并症的胎盘结构在很大程度上仍未得到充分研究，尽管其负担很重。本研究旨在比较疟疾-子痫前期合并症与健康妊娠妇女的胎盘特征和新生儿体重。
我们在肯尼亚西部的一家县医院进行了一项回顾性队列研究，纳入了 24 例疟疾-子痫前期合并症妇女和 24 例健康妊娠妇女。比较了两组新生儿体重、胎盘大体和组织形态学特征。
与健康妊娠妇女相比，疟疾-子痫前期合并症妇女的新生儿体重（P<0.001）、胎盘重量（P=0.028）、脐带长度（P<0.001）和脐带直径（P<0.001）显著降低。与健康妊娠妇女相比，疟疾-子痫前期合并症妇女的绒毛成熟度（P=0.016）和绒毛体积密度（P=0.012）显著降低，绒毛血管密度（P<0.007）增加。
与健康妊娠妇女相比，疟疾-子痫前期合并症患者的胎盘绒毛成熟度和绒毛体积密度显著降低，绒毛血管密度代偿性增加。这导致胎盘功能受损，从而导致新生儿体重降低。
