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Placental Histopathologic Changes Associated with Subclinical Malaria Infection and Its Impact on the Fetal Environment

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  • Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana; Instituto de Medicina Tropicales Alexander von Humboldt, and Departamento de Bioquimica, Biologia Molecular y Farmacologia, Facultad de Ciencias y Filosofia, Universidad Peruana Cayetano Heredia, Lima, Peru; Division of Geographic Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama; Laboratorio Investigaciones anti-Parasitos, Universidad Nacional de la Amazonia Peruana, Iquitos, Peru; Department of Medical Parasitology, New York University School of Medicine, New York, New York
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Microscopic examination of placental tissue can provide an accurate assessment of malaria infection during pregnancy. In this cross-sectional study of 193 women in Iquitos, Peru, 1.0% and 6.6% had parasites in the peripheral blood as detected by microscopy and polymerase chain reaction, respectively. However, 22% had placental malaria pigment indicating past, subclinical infections. Placental tissues with pigment from 24 cases were matched by gravidity and month of delivery to 24 controls and histopathologically examined. Cases had significantly higher number of monocytes in the intervillous space (44.7 versus 25.5; P = 0.012). Pigmented monocytes in fetal vessels were present in 33.3% of cases. This study demonstrated that subclinical malarial infection occurred frequently in pregnant women and is associated with increased presence of monocytes in the placenta. Pigmented monocytes in fetal vessels suggest parasites can breach the placental barrier and enter the fetal circulation.

Author Notes

*Address correspondence to OraLee H. Branch, 341 E. 25th Street, OPH-210, New York, NY 10010. E-mail: oralee.branch@nyumc.org

Financial support: This study was supported by the Gorgas Memorial Institute, the Centers for Disease Control and Prevention (grant UR3/CCU 418652 to Falgunee K. Parekh), by RO1 grant Al064831 from the National Institute of Health/National Institute of Allergy and Infectious Disease, and the American Society of Tropical Medicine and Hygiene.

Authors' addresses: Falgunee K. Parekh, 20408 Shore Harbour Drive, #P, Germantown, MD 20874. Billie B. Davison, 300 Reine Street, Mandeville, LA 70471. Dionicia Gamboa, Instituto de Medicina Tropical Alexander von Humboldt and Departmento de Bioquimica, Biologia Molecular y Farmacologia, Facultad de Ciencias y Filosofia, Universidad Peruana Cayetano Heredia, Lima, Peru. Jean Hernandez, Laboratorio de Investigacion en Productos Naturales Antiparasitoarios de la Amazonia, Pasaje Los Paujiles S/N, AA.HH, Nuevo San Lorenzo Iquitos, Peru. OraLee H. Branch, 341 E. 25th Street, OPH-210, New York, NY 10010.

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