PLACENTAL MALARIA PARASITAEMIA AT DELIVERY: A STUDY OF RISK FACTORS AND PERINATAL OUTCOME IN ILE-IFE

Abstract

Introduction: Placental malaria is recognized as a complication of malaria in pregnancy in
endemic areas with adverse effect on obtstetrics and perinatal-outcome. There is the need to
know the prevalence of placental malaria in various environments as well as ascertain its risk and
effect on perinatal outcome.
Objectives: The study was undertaken to determine the prevalence of placental malaria, its risk
factors, and its obstetrics and perinatal outcomes among pregnant women who delivered in
Obafemi Awolowo University Teaching Hospitals Complex, Ile Ife.
Methodology: This study was a cross sectional study carried out over a 6-months period at the
Department of Obstetrics and Gynaecology, Obafemi Awolowo University Teaching Hospitals
Complex, Ile Ife. Eligible parturients were enrolled in labor and questionnaires were
administered to them. Blood sample was taken from each of the mother in labor for packed cell
volume (PCV), blood group and blood film for malaria parasites. Cord blood was taken for PCV
and blood film for malaria parasites while placental blood was taken for blood film for malaria
parasites after delivery. Neonatal anthropometric measurements were recorded in a standardized
proforma.
Results: The prevalence of malaria placental parasitemia was 48% while the prevalence of
peripheral parastemia was 57.7%. There was no correlation between peripheral parasite and
placental parasite densities (r=0.29, P<0.001). Three hundred parturients were studied out of
which 144 (48%) had placental malaria parasitaemia. There was a significant inverse relationship
between prevalence of placental parasitaemia and parity (P=0.04). Maternal age less than 20
years (P=0.008), and heamoglobin type AA (P=0.002) were significantly associated with higher
prevalence of placental parasitaemia, while use of both IPT and ITN in pregnancy (P=0.003),
and tertiary maternal education (P=0.013) were significantly associated with lower prevalence.
There was a siginificant association between placental parasitaemia and maternal anaemia
(P<0.001), as well as low birth weight (P<0.001).
Conclusion: Placental parasitaemia constitutes a major challenge in pregnancy as it is
significantly and adversely associated with perinatal outcomes such as low birth weight and
preterm delivery as well as with maternal anaemia. IPT was found to significantly reduce
placental parasitemia while maternal characteristics such as young mothers (less than 20 years)
and low parity increase the risk. There is therefore the need to intensify control efforts aimed at
reducing malaria in pregnancy in Nigeria, and mothers with increased risk factors should receive
more focused attention.

PLACENTAL MALARIA PARASITAEMIA AT DELIVERY: A STUDY OF RISK FACTORS AND PERINATAL OUTCOME IN ILE-IFE