Prenatal malaria exposure and risk of adverse birth outcomes: a prospective cohort study of pregnant women in the Northern Region of Ghana

Objective Malaria remains endemic in most of sub-Saharan Africa and has a negative impact among pregnant women, resulting in morbidity and poor birth outcomes. The purpose of this study was to assess the relationship between malaria and adverse birth outcomes among prenatal women in the Northern Reg...

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Main Authors: Akbar Fotouhi, Masud Yunesian, Hawawu Hussein, Mansour Shamsipour, Mohammad Sadegh Hassanvand, Percival Delali Agordoh, Mashoud Alabi Seidu
Format: Article
Language:English
Published: BMJ Publishing Group 2022-08-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/12/8/e058343.full
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author Akbar Fotouhi
Masud Yunesian
Hawawu Hussein
Mansour Shamsipour
Mohammad Sadegh Hassanvand
Percival Delali Agordoh
Mashoud Alabi Seidu
author_facet Akbar Fotouhi
Masud Yunesian
Hawawu Hussein
Mansour Shamsipour
Mohammad Sadegh Hassanvand
Percival Delali Agordoh
Mashoud Alabi Seidu
author_sort Akbar Fotouhi
collection DOAJ
description Objective Malaria remains endemic in most of sub-Saharan Africa and has a negative impact among pregnant women, resulting in morbidity and poor birth outcomes. The purpose of this study was to assess the relationship between malaria and adverse birth outcomes among prenatal women in the Northern Region of Ghana.Design This is a prospective cohort study of singleton pregnancies at 28 weeks of gestational age and above recruited between July 2018 and May 2019 from four public hospitals in the Northern Region of Ghana.Outcome measures Low birth weight (LBW), preterm birth and perinatal death.Results A total of 1323 pregnant women completed the study out of the 1626 recruited, with an average age of 27.3±5.2 years. The incidence of malaria in this population was 9.5% (95% CI 7.9 to 11.1). After adjusting for newborn admissions to the neonatal intensive care unit, parity, maternal age and glucose-6-phosphate dehydrogenase, women who were exposed to malaria during the third trimester of pregnancy had 2.02 times (95% CI 1.36 to 2.99) higher odds of premature delivery. Furthermore, they had 2.06 times (95% CI 1.09 to 3.93) higher chance of giving birth to babies with LBW, irrespective of their socioeconomic status. With an OR of 1.02 (95% CI 0.26 to 4.01), there was no difference in perinatal mortality between pregnant women with malaria and those without malaria after adjusting for caesarean section.Conclusion This study confirms that prenatal malaria increases the odds of both preterm and LBW deliveries. A decisive policy to eradicate or minimise perinatal malaria is needed to contribute to the prevention of LBW and adverse pregnancy outcomes.
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spelling doaj.art-bc0ec3bf3a9b4f01a609856275c3fc762022-12-22T00:53:17ZengBMJ Publishing GroupBMJ Open2044-60552022-08-0112810.1136/bmjopen-2021-058343Prenatal malaria exposure and risk of adverse birth outcomes: a prospective cohort study of pregnant women in the Northern Region of GhanaAkbar Fotouhi0Masud Yunesian1Hawawu Hussein2Mansour Shamsipour3Mohammad Sadegh Hassanvand4Percival Delali Agordoh5Mashoud Alabi Seidu6Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran4Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, IranDepartment of Statistical Sciences, Faculty of Applied Science and Technology, Tamale Technical University, Tamale, GhanaDepartment of Research Methodology and Data Analysis, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)Center for Air Pollution Research (CAPR), Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)Department of Nutrition and Dietetics, School of Allied Health Sciences, University of Health and Allied Sciences, Ho, GhanaDepartment of Research, Tamale Teaching Hospital, Tamale, GhanaObjective Malaria remains endemic in most of sub-Saharan Africa and has a negative impact among pregnant women, resulting in morbidity and poor birth outcomes. The purpose of this study was to assess the relationship between malaria and adverse birth outcomes among prenatal women in the Northern Region of Ghana.Design This is a prospective cohort study of singleton pregnancies at 28 weeks of gestational age and above recruited between July 2018 and May 2019 from four public hospitals in the Northern Region of Ghana.Outcome measures Low birth weight (LBW), preterm birth and perinatal death.Results A total of 1323 pregnant women completed the study out of the 1626 recruited, with an average age of 27.3±5.2 years. The incidence of malaria in this population was 9.5% (95% CI 7.9 to 11.1). After adjusting for newborn admissions to the neonatal intensive care unit, parity, maternal age and glucose-6-phosphate dehydrogenase, women who were exposed to malaria during the third trimester of pregnancy had 2.02 times (95% CI 1.36 to 2.99) higher odds of premature delivery. Furthermore, they had 2.06 times (95% CI 1.09 to 3.93) higher chance of giving birth to babies with LBW, irrespective of their socioeconomic status. With an OR of 1.02 (95% CI 0.26 to 4.01), there was no difference in perinatal mortality between pregnant women with malaria and those without malaria after adjusting for caesarean section.Conclusion This study confirms that prenatal malaria increases the odds of both preterm and LBW deliveries. A decisive policy to eradicate or minimise perinatal malaria is needed to contribute to the prevention of LBW and adverse pregnancy outcomes.https://bmjopen.bmj.com/content/12/8/e058343.full
spellingShingle Akbar Fotouhi
Masud Yunesian
Hawawu Hussein
Mansour Shamsipour
Mohammad Sadegh Hassanvand
Percival Delali Agordoh
Mashoud Alabi Seidu
Prenatal malaria exposure and risk of adverse birth outcomes: a prospective cohort study of pregnant women in the Northern Region of Ghana
BMJ Open
title Prenatal malaria exposure and risk of adverse birth outcomes: a prospective cohort study of pregnant women in the Northern Region of Ghana
title_full Prenatal malaria exposure and risk of adverse birth outcomes: a prospective cohort study of pregnant women in the Northern Region of Ghana
title_fullStr Prenatal malaria exposure and risk of adverse birth outcomes: a prospective cohort study of pregnant women in the Northern Region of Ghana
title_full_unstemmed Prenatal malaria exposure and risk of adverse birth outcomes: a prospective cohort study of pregnant women in the Northern Region of Ghana
title_short Prenatal malaria exposure and risk of adverse birth outcomes: a prospective cohort study of pregnant women in the Northern Region of Ghana
title_sort prenatal malaria exposure and risk of adverse birth outcomes a prospective cohort study of pregnant women in the northern region of ghana
url https://bmjopen.bmj.com/content/12/8/e058343.full
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