Author:
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Accrombessi, Manfred; Ouédraogo, Smaila; Agbota, Gino Cédri; González, Raquel; Massougbodji, Achille; Menéndez, Clara; Cot, Michel
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Abstract:
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BACKGROUND: Anaemia is an increasingly recognized health problem
in Africa, particularly in infants and pregnant women. Although
malaria is known to be the main risk factor of anaemia in both
groups, the consequences of maternal factors, particularly
malaria in pregnancy (MiP), on infant haemoglobin (Hb)
concentrations during the first months of life are still
unclear. METHODS: We followed-up a cohort of 1005 Beninese
pregnant women from the beginning of pregnancy until delivery. A
subsample composed of the first 400 offspring of these women
were selected at birth and followed until the first year of
life. Placental histology and blood smear at 1st clinical
antenatal visit (ANC), 2nd ANC and delivery were used to assess
malaria during pregnancy. Infant Hb concentrations were measured
at birth, 6, 9 and 12 months of age. A mixed multi-level model
was used to assess the association between MiP and infant Hb
variations during the first 12 months of life. RESULTS:
Placental malaria (difference mean [dm] = - 2.8 g/L, 95% CI
[-5.3, -0.3], P = 0.03) and maternal peripheral parasitaemia at
delivery (dm = - 4.6 g/L, 95% CI [-7.9, -1.3], P = 0.007) were
the main maternal factors significantly associated with infant
Hb concentrations during the first year of life. Poor maternal
nutritional status and malaria infection during infancy were
also significantly associated with a decrease in infant Hb.
CONCLUSION: Antimalarial control and nutritional interventions
before and during pregnancy should be reinforced to reduce
specifically the incidence of infant anaemia, particularly in
Sub-Saharan countries. |