PLACENTAL MONOCYTE INFILTRATES IN RESPONSE TO PLASMODIUM FALCIPARUM MALARIA INFECTION AND THEIR ASSOCIATION WITH ADVERSE PREGNANCY OUTCOMES

STEPHEN J. ROGERSON Malawi-Liverpool-Wellcome Trust Clinical Research Programme, College of Medicine, University of Malawi, Blantyre, Malawi; School of Tropical Medicine, University of Liverpool, Liverpool, UK; Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Melbourne, Australia; Department of Histopathology, Kings College Hospital, London; Department of Histopathology, College of Medicine, University of Malawi, Blantyre, Malawi; Department of Obstetrics and Gynaecology, College of Medicine, University of Malawi, Blantyre, Malawi

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ELENA POLLINA Malawi-Liverpool-Wellcome Trust Clinical Research Programme, College of Medicine, University of Malawi, Blantyre, Malawi; School of Tropical Medicine, University of Liverpool, Liverpool, UK; Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Melbourne, Australia; Department of Histopathology, Kings College Hospital, London; Department of Histopathology, College of Medicine, University of Malawi, Blantyre, Malawi; Department of Obstetrics and Gynaecology, College of Medicine, University of Malawi, Blantyre, Malawi

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ABERA GETACHEW Malawi-Liverpool-Wellcome Trust Clinical Research Programme, College of Medicine, University of Malawi, Blantyre, Malawi; School of Tropical Medicine, University of Liverpool, Liverpool, UK; Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Melbourne, Australia; Department of Histopathology, Kings College Hospital, London; Department of Histopathology, College of Medicine, University of Malawi, Blantyre, Malawi; Department of Obstetrics and Gynaecology, College of Medicine, University of Malawi, Blantyre, Malawi

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EYOB TADESSE Malawi-Liverpool-Wellcome Trust Clinical Research Programme, College of Medicine, University of Malawi, Blantyre, Malawi; School of Tropical Medicine, University of Liverpool, Liverpool, UK; Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Melbourne, Australia; Department of Histopathology, Kings College Hospital, London; Department of Histopathology, College of Medicine, University of Malawi, Blantyre, Malawi; Department of Obstetrics and Gynaecology, College of Medicine, University of Malawi, Blantyre, Malawi

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VALENTINO M. LEMA Malawi-Liverpool-Wellcome Trust Clinical Research Programme, College of Medicine, University of Malawi, Blantyre, Malawi; School of Tropical Medicine, University of Liverpool, Liverpool, UK; Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Melbourne, Australia; Department of Histopathology, Kings College Hospital, London; Department of Histopathology, College of Medicine, University of Malawi, Blantyre, Malawi; Department of Obstetrics and Gynaecology, College of Medicine, University of Malawi, Blantyre, Malawi

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MALCOLM E. MOLYNEUX Malawi-Liverpool-Wellcome Trust Clinical Research Programme, College of Medicine, University of Malawi, Blantyre, Malawi; School of Tropical Medicine, University of Liverpool, Liverpool, UK; Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Melbourne, Australia; Department of Histopathology, Kings College Hospital, London; Department of Histopathology, College of Medicine, University of Malawi, Blantyre, Malawi; Department of Obstetrics and Gynaecology, College of Medicine, University of Malawi, Blantyre, Malawi

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DOI:
https://doi.org/10.4269/ajtmh.2003.68.1.0680115
Volume/Issue:
Volume 68: Issue 1
Page(s):
115–119
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Maternal anemia and low birth weight (LBW) may complicate malaria in pregnancy, and placental monocyte infiltrates have been associated with LBW, and anecdotally with anemia. We examined placental pathology from 357 Malawian women. Intervillous monocyte infiltrates were frequent in placental malaria and were not seen in uninfected placentas. Histology was grouped according to a 5-point scale. Dense monocyte infiltrates and presence of intramonocytic malaria pigment were associated with anemia and LBW. Of factors associated with LBW and/or anemia in univariate analysis, gravidity (P = 0.002), number of antenatal clinic (ANC) visits (P < 0.001), malaria pigment in fibrin (P = 0.03), and monocyte malaria pigment (P = 0.0001) remained associated with lower birth weight by multivariate analysis. Associated with maternal anemia were HIV infection (P < 0.0001), intervillous monocyte numbers (P < 0.0001), number of ANC visits (P = 0.002), and recent febrile symptoms (P = 0.0001). Pigment-containing placental monocytes are associated with anemia and LBW due to malaria, and may have a causative role in their development.

Author Notes

Reprint requests: Dr. S. J. Rogerson, University of Melbourne, Department of Medicine (RMH/WH), Post Office, Royal Melbourne Hospital, Parkville VIC 3050, Australia, Telephone: +61-3-8344-6252, Fax: +61-3-9347-1863, E-mail: sroger@unimelb.edu.au
Copyright:
Copyright 2003 The American Society of Tropical Medicine 2003
Received:
20 Apr 2002
|
Accepted:
14 Oct 2002
|
Published Online:
Jan 2003
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
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