Volume 77, Issue 2
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


The objective of this study was to determine the role of malaria in the etiology of fetal malnutrition in Nigeria. This study took place at the Neonatal and Maternity Units of the Wesley Guild Hospital, Ilesa, Nigeria. This is a prospective study of 304 consecutive, singleton, term live births delivered between January and August 2002. Anthropometric and clinical data were recorded. Fetal malnutrition (FM; failure to acquire adequate quantum of fat and muscle mass during intrauterine growth) was diagnosed using clinical assessment of fetal nutritional status (CANS) and the score (CANSCORE) adapted by Metcoff. The placenta tissues were examined for malaria pigments and parasites, and placental and cord blood smears were examined for parasites. Babies were followed up in the neonatal period for clinical malaria. Babies were grouped into those with malaria-infected placental and cord blood specimens and those without. The two groups were compared with regard to the proportions with FM and complications of FM. Three hundred four placental and cord blood specimens were examined for malaria. Of the 304, 101 (33.2%) of the placental and 67 (22.0%) of the cord blood specimens were positive for malaria. Sixty-six (21.7%) of the 304 babies had FM. Forty-four (66.7%) of the 66 placental blood specimens of babies with FM were positive for malaria, whereas 57 (24.0%) of the 238 placentae of babies without FM had placental malaria (χ =42.5, < 0.0001). Similarly, 27 (40.9%) of 66 babies with FM compared with 40 (16.8%) among 238 babies without FM had malaria parasites in the cord blood (χ =17.5, < 0.001). The means of birth weight, ponderal index, and placenta weight were significantly lower among the babies of mothers with malaria-infected placentae than those without ( < 0.05 in all cases). Lack of antenatal care, primiparity, and failure to have chemoprophylaxis against malaria were the maternal factors found to be associated with placental malaria infection. Placental malaria is a major factor in the etiology of FM in Nigeria.


Article metrics loading...

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

Full text loading...



  1. Brabin BJ, 1983. An analysis of malaria in pregnancy in Africa. Bull World Health Org 61 : 1005–1006. [Google Scholar]
  2. McGregor IA, 1984. Epidemiology, malaria and pregnancy. Am J Trop Med 33 : 517–525. [Google Scholar]
  3. Gilles HM, Lawson JB, Sibelas M, Voller A, Allan N, 1989. Malaria, anaemia and pregnancy. Ann Trop Med Parasitol 63 : 245–263. [Google Scholar]
  4. Nosten F, Ter Kuile F, Maelankiri M, 1991. Malaria in pregnancy in an area of unstable endemicity. Trans R Soc Trop Med Hyg 85 : 424–429. [Google Scholar]
  5. Sowunmi A, Ilesanmi AO, Akindele JA, Abohweyere AEJ, Fawole AO, Falade CO, Oduola AMJ, 1996. Placental falciparum infection and outcome of pregnancy in Nigerian mothers from an endemic area. J Obstet Gynaecol 16 : 212–217. [Google Scholar]
  6. Bachschmid I, Soro B, Coulibaly A, Philippe E, Kingston L, Kien T, Rey JL, 1991. Infection paluduous with the childbirth and resulting from the pregnancy with Bécédi, (Ivory Coast). Bull Exotic Comp Path. 84 : 257–265. [Google Scholar]
  7. Taha T-el-T, Gray RH, Mohamedani A, 1993. Malaria and low birth weight in Central Sudan. Am J Epidemiol 138 : 318–325. [Google Scholar]
  8. 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]
  9. Covell G, 1950. Congenital malaria. Trop Dis Bull 47 : 1147–1167. [Google Scholar]
  10. Bruce-Chwatt LJ, 1952. Malaria in African infants and children in southern Nigeria. Ann Trop Med Parasitol 46 : 173–200. [Google Scholar]
  11. Menendez C, Ordi J, Ismail MR, Ventura PJ, Aponte JJ, Kahigwa E, Font F, Alonso PL, 2000. Impact of placental malaria on gestational age and birthweight. J Infect Dis 181 : 1740–1745. [Google Scholar]
  12. World Health Organization, 1992. Low birth weight: a tabulation of available information. Maternal Health and Safe Motherhood Programme. Geneva, WHO/MCH/92.2.
  13. Adebami OJ, 2004. The Incidence and Problems of Foetal Malnutrition in Term Babies at Wesley Guild Hospital [WGH], Ilesa, Southwestern Nigeria. Postgraduate fellowship examination dissertation, West African College of Physicians, Vagos, Nigeria.
  14. Hill RM, Verniaud WM, Deter RL, Tennyson LM, Rettig GM, Zion TE, Vorderman AL, Helms PG, McCulley LB, and Hill LL, 1984. The effects of intrauterine malnutrition on the term infants. A 14-year progressive study. Acta Paediatr Scand 73 : 482–487. [Google Scholar]
  15. Wynn M, Wynn A, 1981. The importance of nutrition around the time of the fetus at different stages of gestation. Bateman EC, ed. Applied Nutrition. London: Libby, 12–19.
  16. Metcoff J, 1994. Clinical assessment of nutritional status at birth. Fetal malnutrition and SGA are not synonymous. Pediatr Clin North Am 41 : 875–891. [Google Scholar]
  17. Brueton MJ, Palit A, Prosser R, 1973. Gestational age assessment in Nigerian newborn infants. Arch Dis Child 48 : 318–320. [Google Scholar]
  18. Dawodu AH, Effiong CE, 1977. Assessment of gestational age in full term and preterm African newborn infants. Nig J Paediatr 4 : 1–5. [Google Scholar]
  19. Walter PR, Garin Y, Blot P, 1982. Placental pathologic changes in malaria. A histologic and ultrastructural study. Am J Pathol 109 : 330–342. [Google Scholar]
  20. Bulmer JN, Rasheed FN, Francis N, Morrison L, Greenwood BM, 1993. Placental malaria 1. Pathological classification of placenta malaria. Histopathology 22 : 211–228. [Google Scholar]
  21. McGregor IA, Wilson ME, Billewicz WZ, 1983. Malaria infection of the placenta in the Gambia, West Africa: its incidence and relationship to stillbirths, birth weight. Trans R Soc Trop Med Hyg 77 : 282–284. [Google Scholar]
  22. Ezeoke ACJ, Ibanga NJ, Braide EI, 1985. Congenital malaria at University of Calabar Teaching Hospital with reference to haemoglobin and immunoglobin. Central Afri J Med 31 : 241–247. [Google Scholar]
  23. Obiajunwa PO, 1999. Point Prevalence of Congenital Malaria in Ife State Hospital. Postgraduate fellowship examination dissertation, West African College of Physicians, Lagos, Nigeria.
  24. Marsh K, 1993. Immunology of human malaria Gilles HM, Warrell DA, eds. Essential Malariology. London: Edward Arnold, 60–77.
  25. Jayant D, Rajkumar J, 1999. Study of the prevalence and high risk factors for foetal malnutrition in term newborns. Ann Trop Paediatr 19 : 273–277. [Google Scholar]
  26. Fried M, Muga OR, Misore AO, Duffy PE, 1998. Malaria elicits type 1 cytokines in the human placenta: IFN-γand TNF-αassociated with pregnancy outcomes. J Immunol 160 : 2523–2530. [Google Scholar]
  27. Warrell DA, 1983. Clinical features of malaria. Gilles HM, Warrell DA, eds. Essential Malariology. London: Edward Arnold, 35–49.

Data & Media loading...

  • Received : 04 Aug 2006
  • Accepted : 30 Apr 2007

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