LOGIN TO YOUR ACCOUNT

Username
Password
Remember Me
Or use your Academic/Social account:

CREATE AN ACCOUNT

Or use your Academic/Social account:

Congratulations!

You have just completed your registration at OpenAire.

Before you can login to the site, you will need to activate your account. An e-mail will be sent to you with the proper instructions.

Important!

Please note that this site is currently undergoing Beta testing.
Any new content you create is not guaranteed to be present to the final version of the site upon release.

Thank you for your patience,
OpenAire Dev Team.

Close This Message

CREATE AN ACCOUNT

Name:
Username:
Password:
Verify Password:
E-mail:
Verify E-mail:
*All Fields Are Required.
Please Verify You Are Human:
fbtwitterlinkedinvimeoflicker grey 14rssslideshare1
Abrams, Elizabeth T; Kwiek, Jesse J; Mwapasa, Victor; Kamwendo, Deborah D; Tadesse, Eyob; Lema, Valentino M; Molyneux, Malcolm E; Rogerson, Stephen J; Meshnick, Steven R (2005)
Publisher: BioMed Central
Journal: Malaria Journal
Languages: English
Types: Article
Subjects: wc_750, RC955-962, RC109-216, wq_200, Infectious and parasitic diseases, ws_141, Caltech Library Services, wq_240, Arctic medicine. Tropical medicine, Research, R1

Classified by OpenAIRE into

mesheuropmc: parasitic diseases

Abstract

Background

Although maternal anaemia often stems from malaria infection during pregnancy, its effects on foetal haemoglobin levels are not straightforward. Lower-than-expected cord haemoglobin values in malarious versus non-malarious regions were noted by one review, which hypothesized they resulted from foetal immune activation to maternal malaria. This study addressed this idea by examining cord haemoglobin levels in relation to maternal malaria, anaemia, and markers of foetal immune activation.

Methods

Cord haemoglobin levels were examined in 32 malaria-infected and 58 uninfected women in Blantyre, Malawi, in relation to maternal haemoglobin levels, malaria status, and markers of foetal haematological status, hypoxia, and inflammation, including TNF-α, TGF-β, and ferritin. All women were HIV-negative.

Results

Although malaria was associated with a reduction in maternal haemoglobin (10.8 g/dL vs. 12.1 g/dL, p < 0.001), no reduction in cord haemoglobin and no significant relationship between maternal and cord haemoglobin levels were found. Cord blood markers of haematological and hypoxic statuses did not differ between malaria-infected and uninfected women. Maternal malaria was associated with decreased TGF-β and increased cord ferritin, the latter of which was positively correlated with parasitaemia (r = 0.474, p = 0.009). Increased cord ferritin was associated with significantly decreased birth weight and gestational length, although maternal and cord haemoglobin levels and malaria status had no effect on birth outcome.

Conclusion

In this population, cord haemoglobin levels were protected from the effect of maternal malaria. However, decreased TGF-β and elevated ferritin levels in cord blood suggest foetal immune activation to maternal malaria, which may help explain poor birth outcomes.

  • The results below are discovered through our pilot algorithms. Let us know how we are doing!

    • 1. Brabin BJ: An analysis of malaria in pregnancy in Africa. Bull World Health Organ 1983, 61:1005-1016.
    • 2. Menendez C, Ordi J, Ismail MR, Ventura PJ, Aponte JJ, Kahigwa E, Font F, Alonso PL: The impact of placental malaria on gestational age and birth weight. J Infect Dis 2000, 181:1740-1745.
    • 3. Menendez C, Fleming AF, Alonso PL: Malaria-related anaemia. Parasitol Today 2000, 16:469-476.
    • 4. Brabin B: Foetal anaemia in malarious areas: its causes and significance. Ann Trop Paediatr 1992, 12:303-310.
    • 5. Erdem A, Erdem M, Arslan M, Yazici G, Eskandari R, Himmetoglu O: The effect of maternal anaemia and iron deficiency on fetal erythropoiesis: comparison between serum erythropoietin, haemoglobin and ferritin levels in mothers and newborns. J Matern Fetal Neonatal Med 2002, 11:329-332.
    • 6. Hokama T, Takenaka S, Hirayama K, Yara A, Yoshida K, Itokazu K, Kinjho R, Yabu E: Iron status of newborns born to iron deficient anaemic mothers. J Trop Pediatr 1996, 42:75-77.
    • 7. Agarwal KN, Krishna M, Singla PN, Jain A: Effects of hematinic and protein supplementation on the feto-placental unit in maternal anaemia. Indian Pediatr 1984, 21:765-771.
    • 8. Tracer DP: Reproductive and socio-economic correlates of maternal haemoglobin levels in a rural area of Papua New Guinea. Trop Med Int Health 1997, 2:513-518.
    • 9. Bhargava M, Iyer PU, Kumar R, Ramji S, Kapani V, Bhargava SK: Relationship of maternal serum ferritin with foetal serum ferritin, birth weight and gestation. J Trop Pediatr 1991, 37:149-152.
    • 10. Ballew C, Haas JD: Haematologic evidence of foetal hypoxia among newborn infants at high altitude in Bolivia. Am J Obstet Gynecol 1986, 155:166-169.
    • 11. Abdalla SH: Haematopoiesis in human malaria. Blood Cells 1990, 16:401-416. discussion 417-409
    • 12. Huddle JM, Gibson RS, Cullinan TR: The impact of malarial infection and diet on the anaemia status of rural pregnant Malawian women. Eur J Clin Nutr 1999, 53:792-801.
    • 13. Rogerson SJ, Pollina E, Getachew A, Tadesse E, Lema VM, Molyneux ME: Placental monocyte infiltrates in response to Plasmodium falciparum malaria infection and their association with adverse pregnancy outcomes. Am J Trop Med Hyg 2003, 68:115-119.
    • 14. Fried M, Muga RO, Misore AO, Duffy PE: Malaria elicits type 1 cytokines in the human placenta: IFN-gamma and TNFalpha associated with pregnancy outcomes. J Immunol 1998, 160:2523-2530.
    • 15. Rogerson SJ, Brown HC, Pollina E, Abrams ET, Tadesse E, Lema VM, Molyneux ME: Placental tumor necrosis factor alpha but not gamma interferon is associated with placental malaria and low birth weight in Malawian women. Infect Immun 2003, 71:267-270.
    • 16. Moormann AM, Sullivan AD, Rochford RA, Chensue SW, Bock PJ, Nyirenda T, Meshnick SR: Malaria and pregnancy: placental cytokine expression and its relationship to intrauterine growth retardation. J Infect Dis 1999, 180:1987-1993.
    • 17. Fievet N, Ringwald P, Bickii J, Dubois B, Maubert B, Le Hesran JY, Cot M, Deloron P: Malaria cellular immune responses in neonates from Cameroon. Parasite Immunol 1996, 18:483-490.
    • 18. King CL, Malhotra I, Wamachi A, Kioko J, Mungai P, Wahab SA, Koech D, Zimmerman P, Ouma J, Kazura JW: Acquired immune responses to Plasmodium falciparum merozoite surface protein-1 in the human foetus. J Immunol 2002, 168:356-364.
    • 19. Buescher U, Hertwig K, Wolf C, Dudenhausen JW: Erythropoietin in amniotic fluid as a marker of chronic foetal hypoxia. Int J Gynaecol Obstet 1998, 60:257-263.
    • 20. Allen LH: Biological mechanisms that might underlie iron's effects on foetal growth and preterm birth. J Nutr 2001, 131:581S-589S.
    • 21. Pacifici GM, Nottoli R: Placental transfer of drugs administered to the mother. Clin Pharmacokinet 1995, 28:235-269.
    • 22. Zanjani ED, Pixley JS, Slotnick N, MacKintosh FR, Ekhterae D, Clemons G: Erythropoietin does not cross the placenta into the foetus. Pathobiology 1993, 61:211-215.
    • 23. Starreveld JS, Kroos MJ, Van Suijlen JD, Verrijt CE, Van Eijk HG, Van Dijk JP: Ferritin in cultured human cytotrophoblasts: synthesis and subunit distribution. Placenta 1995, 16:383-395.
    • 24. Zaretsky MV, Alexander JM, Byrd W, Bawdon RE: Transfer of inflammatory cytokines across the placenta. Obstet Gynecol 2004, 103:546-550.
    • 25. Gutteberg TJ, Askvik K, Jorgensen T: Serum lactoferrin and Creactive protein in mother and newborn after preterm rupture of membranes. Acta Obstet Gynecol Scand 1986, 65:203-205.
    • 26. Yang K: Placental 11 beta-hydroxysteroid dehydrogenase: barrier to maternal glucocorticoids. Rev Reprod 1997, 2:129-132.
    • 27. Mwapasa V, Rogerson SJ, Molyneux ME, Abrams ET, Kamwendo DD, Lema VM, Tadesse E, Chaluluka E, Wilson PE, Meshnick SR: The effect of Plasmodium falciparum malaria on peripheral and placental HIV-1 RNA concentrations in pregnant Malawian women. Aids 2004, 18:1051-1059.
    • 28. Ballard JL, Khoury KC, Wedig K, Wang L, Eilers-Walsman BL, Lipp R: New Ballard Score, expanded to include extremely premature infants. J Pediatr 1991, 119:417-423.
    • 29. Rogerson SJ, Chaluluka E, Kanjala M, Mkundika P, Mhango C, Molyneux ME: Intermittent sulfadoxine-pyrimethamine in pregnancy: effectiveness against malaria morbidity in Blantyre, Malawi, in 1997-99. Trans R Soc Trop Med Hyg 2000, 94:549-553.
    • 30. Sokal RR, Rohlf FJ: Biometry New York: W. H. Freeman and Company; 1995.
    • 31. Fletcher J, Suter PE: The transport of iron by the human placenta. Clin Sci 1969, 36:209-220.
    • 32. Weinberg ED: Nutritional immunity. Host's attempt to withold iron from microbial invaders. Jama 1975, 231:39-41.
    • 33. Rondo PH, Tomkins AM: Maternal iron status and intrauterine growth retardation. Trans R Soc Trop Med Hyg 1999, 93:423-426.
    • 34. Arbeille P, Carles G, Bousquet F, Body G, Lansac J: Foetal cerebral and umbilical artery blood flow changes during pregnancy complicated by malaria. J Ultrasound Med 1998, 17:223-229.
    • 35. Vora M, Gruslin A: Erythropoietin in obstetrics. Obstet Gynecol Surv 1998, 53:500-508.
    • 36. Ostlund E, Lindholm H, Hemsen A, Fried G: Foetal erythropoietin and endothelin-1: relation to hypoxia and intrauterine growth retardation. Acta Obstet Gynecol Scand 2000, 79:276-282.
    • 37. Burchard GD, Radloff P, Philipps J, Nkeyi M, Knobloch J, Kremsner PG: Increased erythropoietin production in children with severe malarial anaemia. Am J Trop Med Hyg 1995, 53:547-551.
    • 38. Nussenblatt V, Mukasa G, Metzger A, Ndeezi G, Garrett E, Semba RD: Anaemia and interleukin-10, tumor necrosis factor alpha, and erythropoietin levels among children with acute, uncomplicated Plasmodium falciparum malaria. Clin Diagn Lab Immunol 2001, 8:1164-1170.
    • 39. Verhoef H, West CE, Kraaijenhagen R, Nzyuko SM, King R, Mbandi MM, van Laatum S, Hogervorst R, Schep C, Kok FJ: Malarial anaemia leads to adequately increased erythropoiesis in asymptomatic Kenyan children. Blood 2002, 100:3489-3494.
    • 40. el Hassan AM, Saeed AM, Fandrey J, Jelkmann W: Decreased erythropoietin response in Plasmodium falciparum malaria-associated anaemia. Eur J Haematol 1997, 59:299-304.
    • 41. Vedovato M, De Paoli Vitali E, Dapporto M, Salvatorelli G: Defective erythropoietin production in the anaemia of malaria. Nephrol Dial Transplant 1999, 14:1043-1044.
    • 42. Mostello D, Chalk C, Khoury J, Mack CE, Siddiqi TA, Clark KE: Chronic anaemia in pregnant ewes: maternal and foetal effects. Am J Physiol 1991, 261:R1075-1083.
  • No related research data.
  • No similar publications.

Share - Bookmark

Funded by projects

  • WT

Cite this article