Influence of the Timing of Malaria Infection during Pregnancy on Birth Weight and on Maternal Anemia in Benin

Bich-Tram Huynh Institut de Recherche pour le Développement (IRD), UMR216, Mère et Enfant Face aux Infections Tropicales, Paris, France; Faculté de Pharmacie, Université Paris Descartes, Paris, France; Faculté des Sciences de la Santé (FSS), Cotonou, Benin; Comé District Hospital, Comé, Bénin

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Nadine Fievet Institut de Recherche pour le Développement (IRD), UMR216, Mère et Enfant Face aux Infections Tropicales, Paris, France; Faculté de Pharmacie, Université Paris Descartes, Paris, France; Faculté des Sciences de la Santé (FSS), Cotonou, Benin; Comé District Hospital, Comé, Bénin

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Gildas Gbaguidi Institut de Recherche pour le Développement (IRD), UMR216, Mère et Enfant Face aux Infections Tropicales, Paris, France; Faculté de Pharmacie, Université Paris Descartes, Paris, France; Faculté des Sciences de la Santé (FSS), Cotonou, Benin; Comé District Hospital, Comé, Bénin

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Sébastien Dechavanne Institut de Recherche pour le Développement (IRD), UMR216, Mère et Enfant Face aux Infections Tropicales, Paris, France; Faculté de Pharmacie, Université Paris Descartes, Paris, France; Faculté des Sciences de la Santé (FSS), Cotonou, Benin; Comé District Hospital, Comé, Bénin

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Sophie Borgella Institut de Recherche pour le Développement (IRD), UMR216, Mère et Enfant Face aux Infections Tropicales, Paris, France; Faculté de Pharmacie, Université Paris Descartes, Paris, France; Faculté des Sciences de la Santé (FSS), Cotonou, Benin; Comé District Hospital, Comé, Bénin

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Blaise Guézo-Mévo Institut de Recherche pour le Développement (IRD), UMR216, Mère et Enfant Face aux Infections Tropicales, Paris, France; Faculté de Pharmacie, Université Paris Descartes, Paris, France; Faculté des Sciences de la Santé (FSS), Cotonou, Benin; Comé District Hospital, Comé, Bénin

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Achille Massougbodji Institut de Recherche pour le Développement (IRD), UMR216, Mère et Enfant Face aux Infections Tropicales, Paris, France; Faculté de Pharmacie, Université Paris Descartes, Paris, France; Faculté des Sciences de la Santé (FSS), Cotonou, Benin; Comé District Hospital, Comé, Bénin

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Nicaise Tuikue Ndam Institut de Recherche pour le Développement (IRD), UMR216, Mère et Enfant Face aux Infections Tropicales, Paris, France; Faculté de Pharmacie, Université Paris Descartes, Paris, France; Faculté des Sciences de la Santé (FSS), Cotonou, Benin; Comé District Hospital, Comé, Bénin

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Philippe Deloron Institut de Recherche pour le Développement (IRD), UMR216, Mère et Enfant Face aux Infections Tropicales, Paris, France; Faculté de Pharmacie, Université Paris Descartes, Paris, France; Faculté des Sciences de la Santé (FSS), Cotonou, Benin; Comé District Hospital, Comé, Bénin

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Michel Cot Institut de Recherche pour le Développement (IRD), UMR216, Mère et Enfant Face aux Infections Tropicales, Paris, France; Faculté de Pharmacie, Université Paris Descartes, Paris, France; Faculté des Sciences de la Santé (FSS), Cotonou, Benin; Comé District Hospital, Comé, Bénin

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Although consequences of malaria in pregnancy are well known, the period of pregnancy in which infection has the highest impact is still unclear. In Benin, we followed up a cohort of 1,037 women through pregnancy until delivery. The objective was to evaluate the relationship between the timing of infection and birth weight, and maternal anemia at delivery. At the beginning of pregnancy, peripheral infections were associated with a decrease in mean birth weight (−98.5 g; P = 0.03) and an increase in the risk of anemia at delivery (adjusted odds ratio [aOR] = 1.6; P = 0.03). Infections in late pregnancy were related to a higher risk of maternal anemia at delivery (aOR = 1.7; P = 0.001). To fully protect the women during the whole pregnancy, already implemented measures (insecticide-treated nets and intermittent preventive treatment) should be reinforced. In the future, a vaccine against pregnancy-associated malaria parasites could protect the women in early pregnancy, which seems to be a high-risk period.

Author Notes

*Address correspondence to Bich-Tram Huynh, Institut de Recherche pour le Developpement, IRD/UMR 216, Mère et Enfant Face aux Infections Tropicales, 4 avenue de l'Observatoire, 75270, Paris cedex 06, France. E-mail: bichtrambe@hotmail.com

Financial support: For their financial support, we thank Exxon Mobil and the GSK foundation (BTH funding).

Disclosure: This paper describes work undertaken in the context of the STOPPAM project, “Strategies To Prevent Pregnancy-Associated Malaria” (www.stoppam.org). STOPPAM is a Small and Medium Scale Collaborative Project supported by the European 7th Framework Programme, contract no.: 200889.

Authors' addresses: Bich-Tram Huynh, Nadine Fievet, Nicaise Tuikue Ndam, Philippe Deloron, and Michel Cot, Institut de Recherche pour le Développement (IRD), Mère et Enfant Face aux Infections Tropicales, Paris, France, and Faculté de Pharmacie, Université Paris Descartes, Paris, France, E-mails: bichtrambe@hotmail.com, fievet@ird.fr, nicaise.ndam@ird.fr, philippe.deloron@ird.fr, and michel.cot@ird.fr. Gildas Gbaguidi, Sébastien Dechavanne, and Sophie Borgella, Institut de Recherche pour le Développement (IRD), UMR216, Mère et Enfant Face aux Infections Tropicales, Paris, France, E-mails: gildas.gbaguidi@ird.fr, sebdechavanne@yahoo.fr, and sophie.borgella@ird.fr. Blaise Guézo Mévo, Hôpital de Comé, Comé, Bénin, E-mail: guemebla@yahoo.fr. Achille Massougbodji, Faculté des Sciences de la Santé (FSS), UER de Parasitologie, Université de Cotonou, Cotonou, Bénin, E-mail: massougbodjiachille@yahoo.fr.

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