Malaria has no effect on birth weight in Rwanda.

Area of Science:

• Public Health
• Epidemiology
• Obstetrics

Background:

• Malaria negatively affects pregnancy outcomes like low birth weight, premature birth, and stillbirths, especially in high-transmission areas.
• Malaria transmission intensity in Rwanda varies by altitude and has decreased between 2002-2007.
• The study investigates the spatial and temporal impact of malaria on birth outcomes in Rwanda.

Purpose of the Study:

• To analyze the association between malaria incidence and obstetric indicators (birth weight, pregnancy outcome) in Rwanda from 2002-2007.
• To determine if altitude influences birth outcomes in relation to malaria transmission.
• To assess changes in birth outcomes and malaria incidence over time and space.

Main Methods:

• Compared obstetric indicators (birth weight, pregnancy outcome) with malaria incidence using data from 12,526 deliveries and national malaria data (2002-2007).
• Utilized mixed-effects models and logistic regression to analyze associations over time and space.
• Collected data from 11 primary health centers across different malaria endemic areas in Rwanda.

Main Results:

• Birth weight significantly increased over the years (p < 0.001) with seasonal fluctuations, but malaria incidence had no significant effect.
• Malaria incidence showed a slight but significant decreasing effect on premature delivery (p=0.045) and stillbirth (p=0.009).
• Altitude correlated negatively with birth weight; premature delivery and stillbirth rates decreased over the study period (p=0.010 and p=0.036, respectively).

Conclusions:

• Birth weight and pregnancy outcomes in Rwanda were not directly influenced by malaria incidence during the study period, contrary to findings in other regions.
• Despite declining malaria incidence and increasing mean birth weight, no direct association was found.
• Socio-economic factors and improved nutrition are suggested as potential drivers for improved birth outcomes in recent years.