Volume 76, Issue 5
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


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, = 0.02) and a higher risk of low birth weight (AOR = 1.8, = 0.02). A trend was found between infection before 4 months of pregnancy and a decrease in birth weight (−68 g, = 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.


Article metrics loading...

The graphs shown below represent data from March 2017
Loading full text...

Full text loading...



  1. McGready R, Davison BB, Stepniewska K, Cho T, Shee H, Brockman A, Udomsangpetch R, Looareesuwan S, White NJ, Meshnick SR, Nosten F, 2004. The effects of Plasmodium falciparum and P. vivax infections on placental histopathology in an area of low malaria transmission. Am J Trop Med Hyg 70 : 398–407. [Google Scholar]
  2. Newman RD, Hailemariam A, Jimma D, Degifie A, Kebede D, Rietveld AE, Nahlen BL, Barnwell JW, Steketee RW, Parise ME, 2003. Burden of malaria during pregnancy in areas of stable and unstable transmission in Ethiopia during a nonepidemic year. J Infect Dis 187 : 1765–1772. [Google Scholar]
  3. McGregor IA, 1984. Epidemiology, malaria and pregnancy. Am J Trop Med Hyg 33 : 517–525. [Google Scholar]
  4. Cot M, Brutus L, Pinell V, Ramaroson H, Raveloson A, Rabeson D, Rakotonjanabelo AL, 2002. Malaria prevention during pregnancy in unstable transmission areas: the highlands of Madagascar. Trop Med Int Health 7 : 565–572. [Google Scholar]
  5. Cot M, Deloron P, 2003. Malaria prevention strategies. Br Med Bull 67 : 137–148. [Google Scholar]
  6. Steketee RW, Wirima JJ, Slutsker L, Roberts JM, Khoromana CO, Heymann DL, Breman JG, 1996. Malaria parasite infection during pregnancy and at delivery in mother, placenta, and newborn: efficacy of chloroquine and mefloquine in rural Malawi. Am J Trop Med Hyg 55 : 24–32. [Google Scholar]
  7. Brabin B, Ginny M, Sapau J, Galme K, Paino J, 1990. Consequences of maternal anaemia on outcome of pregnancy in a malaria endemic area in Papua New Guinea. Ann Trop Med Parasitol 84 : 11–24. [Google Scholar]
  8. Sullivan AD, Nyirenda T, Cullinan T, Taylor T, Harlow SD, James SA, Meshnick SR, 1999. Malaria infection during pregnancy: intrauterine growth retardation and preterm delivery in Malawi. J Infect Dis 179 : 1580–1583. [Google Scholar]
  9. Steketee RW, Nahlen BL, Parise ME, Menendez C, 2001. The burden of malaria in pregnancy in malaria-endemic areas. Am J Trop Med Hyg 64 : 28–35. [Google Scholar]
  10. Kramer MS, 1987. Determinants of low birth weight: methodological assessment and meta-analysis. Bull World Health Organ 65 : 663–737. [Google Scholar]
  11. Bloland P, Slutsker L, Steketee RW, Wirima JJ, Heymann DL, Breman JG, 1996. Rates and risk factors for mortality during the first two years of life in rural Malawi. Am J Trop Med Hyg 55 : 82–86. [Google Scholar]
  12. Taha Tel T, Gray RH, Mohamedani AA, 1993. Malaria and low birth weight in central Sudan. Am J Epidemiol 138 : 318–325. [Google Scholar]
  13. Cottrell G, Mary JY, Barro D, Cot M, 2005. Is malarial placental infection related to peripheral infection at any time of pregnancy? Am J Trop Med Hyg 73 : 1112–1118. [Google Scholar]
  14. Cot M, Abel L, Roisin A, Barro D, Yada A, Carnevale P, Feingold J, 1993. Risk factors of malaria infection during pregnancy in Burkina Faso: suggestion of a genetic influence. Am J Trop Med Hyg 48 : 358–364. [Google Scholar]
  15. Robert V, Carnevale P, Ouedraogo V, Petrarca V, Coluzzi M, 1988. Transmission of human malaria in a savanna village of South-West Burkina Faso. Ann Soc Belg Med Trop 68 : 107–121. [Google Scholar]
  16. Van Buuren S, Boshuizen H, Knook D, 1999. Multiple imputation of missing blood pressure covariates in survival analysis. Stat Med 18 : 681–699. [Google Scholar]
  17. Steketee RW, Wirima JJ, Slutsker L, Breman JG, Heymann DL, 1996. Comparability of treatment groups and risk factors for parasitemia at the first antenatal clinic visit in a study of malaria treatment and prevention in pregnancy in rural Malawi. Am J Trop Med Hyg 55 : 17–23. [Google Scholar]
  18. Chavance M, Manfredi R, 2000. Modélisation d’observations incomplètes. Rev Epidém et Santé Publ 48 : 389–400. [Google Scholar]
  19. Steketee RW, Wirima JJ, Hightower AW, Slutsker L, Heymann DL, Breman JG, 1996. The effect of malaria and malaria prevention in pregnancy on offspring birthweight, prematurity, and intrauterine growth retardation in rural Malawi. Am J Trop Med Hyg 55 : 33–41. [Google Scholar]
  20. Bulmer JN, Rasheed FN, Morrison L, Francis N, Greenwood BM, 1993. Placental malaria. II. A semi-quantitative investigation of the pathological features. Histopathology 22 : 219–225. [Google Scholar]
  21. Menendez C, Todd J, Alonso PL, Lulat S, Francis N, Greenwood BM, 1994. Malaria chemoprophylaxis, infection of the placenta and birth weight in Gambian primigravidae. J Trop Med Hyg 97 : 244–248. [Google Scholar]
  22. Wirima JJ, Khoromona CO, Steketee RW, Heymann DL, Slutsker L, Coker T, O’Mahoney GJGB, Campbell CC, 1993. Malaria prevention in pregnancy: the effects of treatment and chemoprophylaxis on placental malaria infection, low birth weight, and fetal, infant, and child survival. Atlanta: United States Agency for International Development and US Department of Health and Human Services, 125.
  23. Brabin BJ, 1983. An analysis of malaria in pregnancy in Africa. Bull World Health Organ 61 : 1005–1016. [Google Scholar]
  24. Hernandez-Diaz S, Werler MM, Walker AM, Mitchell AA, 2000. Folic acid antagonists during pregnancy and the risk of birth defects. N Engl J Med 343 : 1608–1614. [Google Scholar]

Data & Media loading...

  • Received : 13 Sep 2006
  • Accepted : 24 Oct 2006

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error