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Am. J. Trop. Med. Hyg., 76(5), 2007, pp. 849-854
Copyright © 2007 by The American Society of Tropical Medicine and Hygiene

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THE IMPORTANCE OF THE PERIOD OF MALARIAL INFECTION DURING PREGNANCY ON BIRTH WEIGHT IN TROPICAL AFRICA

GILLES COTTRELL*, JEAN-YVES MARY, DRISSA BARRO, AND MICHEL COT
Institut de Recherche pour le Développement, Paris, France; INSERM U717, Hôpital Saint-Louis, Université Paris 7, Paris, France; Service d’Anesthésie-Réanimation au Centre Hospitalier Universitaire Souro Sanou de Bobo Dioulasso, Burkina Faso

Malaria in pregnant women is related to low birth weight (LBW), a factor contributing to infant mortality. Which period of infection during pregnancy leads to the most harmful consequences is unclear. We analyzed data collected in Burkina Faso for 1190 pregnant women. Birth weight was analyzed through multivariate linear and logistic regressions. Infection after 6 months of pregnancy was related to a decrease in mean birth weight (–105 g, P = 0.02) and a higher risk of low birth weight (AOR = 1.8, P = 0.02). A trend was found between infection before 4 months of pregnancy and a decrease in birth weight (–68 g, P = 0.08). This suggests that the end of pregnancy is the most important period in terms of public health, but infection at the beginning of pregnancy may also have consequences. Malaria prevention policies should be started early in pregnancy, especially by implementing the systematic use of insecticide-treated nets.

Received September 13, 2006. Accepted for publication October 24, 2006.

Acknowledgements: The authors thank Dr. Hugo Pilkington, for comments regarding the manuscript and the English, Dr. Alzuma Yada, former head of the Banfora Health District, and all the midwives who participated in the study.

Financial support: This study was supported by a grant from the INSERM (Institut National de la Santé et de la Recherche Médicale): réseau Nord-Sud n°486 NS2.

* Address correspondence to Gilles Cottrell, Faculté de Pharmacie Laboratoire de Parasitologie, 4 Avenue de l’Observatoire, 75270 Paris Cedex 06. E-mail: cottrell{at}ird.fr

Authors’ addresses: Gilles Cottrell and Michel Cot, Faculté de Pharmacie, Laboratoire de Parasitologie, 4 Avenue de l’Observatoire 75270 Paris Cedex 06, France. Jean-Yves Mary, INSERM U717, Université Paris 7, DBIM, Hôpital St Louis 1 av Claude Vellefaux, 75010 Paris, France. Drissa Barro, Service d’Anesthésie-Réanimation au Centre Hospitalier Universitaire Souro Sanou de Bobo Dioulasso, B.P 676.

Reprint requests: Gilles Cottrell, Faculté de Pharmacie Laboratoire de Parasitologie, 4 Avenue de l’Observatoire 75270 Paris Cedex 06. Telephone: (33) 1 53 73 15 06, E-mail: cottrell{at}ird.fr.






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