Malaria and pregnancy: the perspective in Pakistan

Area of Science:

• Tropical Medicine
• Obstetrics and Gynecology
• Infectious Diseases

Background:

• Malaria poses a significant threat to pregnant women, potentially leading to adverse pregnancy outcomes.
• Understanding the specific risk factors associated with malaria in pregnancy is crucial for effective management and improved maternal and fetal health.

Purpose of the Study:

• To investigate the effects of malaria infection on pregnancy outcomes.
• To identify clinical and laboratory parameters associated with poor outcomes in pregnant malaria patients.

Main Methods:

• A case-control study was conducted using hospital medical records identified via the ICD-9 coding system.
• Demographic and clinical data were collected and analyzed using SPSS software.
• Patients were categorized based on malaria infection status and pregnancy outcomes.

Main Results:

• The study included multigravid and primigravid patients, with a high percentage exhibiting low platelet counts (<150,000).
• Mean hemoglobin levels were significantly lower in malaria patients (9.4 gm/dl) compared to controls (12.2 gm/dl).
• Plasmodium falciparum was a prevalent species, and various antimalarial treatments were administered. Adverse outcomes included abortion and preterm labor, with lower birth weights observed in infants of malaria-infected mothers.

Conclusions:

• Plasmodium falciparum infection, moderate parasitic load, hemoglobin levels below 10 gm/dL, and platelet counts below 50,000/mm3 are identified as risk factors for poor pregnancy outcomes.
• Intravenous quinine with a loading dose of 20 mg/kg was noted in the context of these risk factors.