Article open access publication

Plasmodium falciparum Infection Early in Pregnancy has Profound Consequences for Fetal Growth.

The Journal of Infectious Diseases, Oxford University Press (OUP), ISSN 0022-1899

Volume 216, 12, 2017

DOI:10.1093/infdis/jix530, Dimensions: pub.1092016930, PMID: 29029247,



  1. (1) Department of Infectious Diseases, Copenhagen University Hospital, Denmark.
  2. (2) University of Copenhagen, grid.5254.6, KU
  3. (3) Tumaini University, grid.412898.e
  4. (4) National Institute for Medical Research, grid.416716.3
  5. (5) Department of Obstetrics and Gynecology, Copenhagen University Hospital, Denmark.
  6. (6) Institut de Recherche pour le Développement, grid.4399.7


Malaria during pregnancy constitutes a large health problem in areas of endemicity. The World Health Organization recommends that interventions are initiated at the first antenatal visit, and these improve pregnancy outcomes. This study evaluated fetal growth by ultrasonography and birth outcomes in women who were infected prior to the first antenatal visit (gestational age, <120 days) and not later in pregnancy. Compared with uninfected controls, women with early Plasmodium falciparum exposure had retarded intrauterine growth between gestational ages of 212 and 253 days (difference between means, 107 g [95% confidence interval {CI}, 26-188]; P = .0099) and a shorter pregnancy duration (difference between means, 6.6 days [95% CI, 1.0-112.5]; P = .0087). The birth weight (difference between means, 221 g [95% CI, 6-436]; P = .044) and the placental weight (difference between means, 84 g [95% CI, 18-150]; P = .013) at term were also reduced. The study suggests that early exposure to P. falciparum, which is not targeted for prevention by current control strategies, has a profound impact on fetal growth, pregnancy duration, and placental weight at term.

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