Leuba Sequoia I, Westreich Daniel, Bose Carl L, Olshan Andrew F, Taylor Steve M, Tshefu Antoinette, Lokangaka Adrien, Carlo Waldemar A, Chomba Elwyn, Mwenechanya Musaku, Liechty Edward A, Bucher Sherri L, Ekhaguere Osayame A, Esamai Fabian, Nyongesa Paul, Jessani Saleem, Saleem Sarah, Goldenberg Robert L, Moore Janet L, Nolen Tracy L, Hemingway-Foday Jennifer, McClure Elizabeth M, Koso-Thomas Marion, Derman Richard J, Hoffman Matthew, Meshnick Steven R, Bauserman Melissa
Department of Epidemiology, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, United States of America.
Department of Pediatrics, University of North Carolina -Chapel Hill, Chapel Hill, North Carolina United States of America.
PLoS One. 2024 Dec 20;19(12):e0310339. doi: 10.1371/journal.pone.0310339. eCollection 2024.
Few studies have assessed the impact of first-trimester malaria infection during pregnancy. We estimated this impact on adverse maternal and pregnancy outcomes.
In a convenience sample of women from the ASPIRIN (Aspirin Supplementation for Pregnancy Indicated risk Reduction In Nulliparas) trial in Kenya, Zambia, and the Democratic Republic of the Congo, we tested for first-trimester Plasmodium falciparum infection using quantitative polymerase chain reaction. We estimated site-specific effects on pregnancy outcomes using parametric g-computation.
Compared to uninfected women, we observed the adjusted site-specific prevalence differences (PDs) among women with first-trimester malaria of the following pregnancy outcomes: preterm birth among Congolese (aPD = 0.06 [99% CI: -0.04, 0.16]), Kenyan (0.03 [-0.04, 0.09]), and Zambian (0.00 [-0.10, 0.20]) women; low birth weight among Congolese (0.07 [-0.03, 0.16]), Kenyan (0.01 [-0.04, 0.06]) and Zambian (-0.04 [-0.13, 0.16]) women; spontaneous abortion among Congolese (0.00 [-0.05, 0.04]), Kenyan (0.00 [-0.04, 0.04]), and Zambian (0.02 [-0.07, 0.24]) women, and anemia later in pregnancy among Congolese (0.04 [-0.09, 0.16]), Kenyan (0.05 [-0.06, 0.17]), and Zambian (0.07 [-0.12, 0.36]) women. The pooled PD for anemia later in pregnancy (26-30 weeks) was 0.08 [99% CI: 0.00, 0.16].
First-trimester malaria was associated with increased prevalence of anemia later in pregnancy. We identified areas for further investigation including effects of first-trimester malaria on preterm birth and low birth weight.
很少有研究评估孕期头三个月疟疾感染的影响。我们估计了这种影响对孕产妇及妊娠不良结局的作用。
在肯尼亚、赞比亚和刚果民主共和国进行的阿司匹林（为降低初产妇妊娠风险补充阿司匹林）试验中，我们选取了一个方便样本中的女性，使用定量聚合酶链反应检测孕期头三个月的恶性疟原虫感染情况。我们使用参数化g计算法估计特定地点对妊娠结局的影响。
与未感染的女性相比，我们观察到孕期头三个月感染疟疾的女性在以下妊娠结局方面经调整后的特定地点患病率差异（PD）：刚果女性的早产（调整后的PD = 0.06 [99%置信区间：-0.04, 0.16]）、肯尼亚女性（0.03 [-0.04, 0.09]）和赞比亚女性（0.00 [-0.10, 0.20]）；刚果女性的低出生体重（0.07 [-0.03, 0.16]）、肯尼亚女性（0.01 [-0.04, 0.06]）和赞比亚女性（-0.04 [-0.13, 0.16]）；刚果女性的自然流产（0.00 [-0.05, 0.04]）、肯尼亚女性（0.00 [-0.04, 0.04]）和赞比亚女性（0.02 [-0.07, 0.24]），以及刚果女性（0.04 [-0.09, 0.16]）、肯尼亚女性（0.05 [-0.06, 0.17]）和赞比亚女性（0.07 [-0.12, 0.36]）在妊娠后期的贫血情况。妊娠后期（26 - 30周）贫血的合并PD为0.08 [99%置信区间：0.00, 0.16]。
孕期头三个月疟疾感染与妊娠后期贫血患病率增加有关。我们确定了需要进一步研究的领域，包括孕期头三个月疟疾对早产和低出生体重的影响。
