[The placenta and malaria. A morphologic, parasitologic and clinical study (author's transl)]

Area of Science:

• Pathology
• Infectious Diseases
• Obstetrics

Context:

• High malaria endemic region (Gabon)
• 115 unselected placentae analyzed
• 35% of placentae showed maternal Plasmodium infection lesions

Purpose:

• Investigate placental lesions from maternal Plasmodium infection
• Determine the impact of these lesions on birth weight
• Correlate placental findings with peripheral parasitemia

Summary:

• Placental lesions characterized by malarial pigment and fibrinoid deposits were observed in 35% of placentae.
• Ultrastructural analysis revealed basal membrane thickening and fibrillary structures.
• Peripheral parasitemia detected in 56% of mothers, but placental lesions only in 65% of these cases.
• No Plasmodium parasites found in cord blood, despite placental presence.
• A statistically significant 220g lower mean birth weight was observed in neonates from mothers with placental lesions.

Impact:

• Highlights the detrimental effect of Plasmodium infection on placental health.
• Establishes a strong link between placental lesions and reduced fetal growth (low birth weight).
• Suggests placental pathology, rather than primiparity, is the primary driver of low birth weight in this context.