Title:Congenital Malaria in Newborns Delivered to Malaria-infected Mothers in the Hilly Region of Northern India: Is it Deadly?
Volume: 18
Issue: 1
Author(s): Avinish Singh, Kriti Mohan*, Balram Ji Omar, Swathi Chacham, Jaya Chaturvedi, Sriparna Basu and Rahul Bhakat
Affiliation:
- Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, India
Keywords:
Congenital malaria, maternal, placenta, small for gestational age, malaria-infected mothers, microbiological spectrum.
Abstract: Background: Malaria is endemic in many states of India. Though there are reports of
maternal and congenital malaria from endemic areas, however, there remains a paucity of data
from hilly terrains. The present study evaluated the prevalence, clinical and microbiological spectrum
of maternal and congenital malaria at a tertiary health care facility in Northern India over a period
of 18 months.
Methods: In this observational study, mothers along with their newborns were evaluated for
malaria by maternal, placental, and cord blood smear examination and rapid point-of-care diagnostic
serological tests. Positive cases were confirmed by polymerase chain reaction. Mother-newborn
duos were followed up till discharge from the hospital.
Results: A total of 843 mothers delivered during the study period and were screened along with
their newborns and placentae. A total of Ten (1.18%) mothers had evidence of malarial parasitemia
(Plasmodium vivax, n=7 and Pl. falciparum, n=3), however, none of the placental and cord blood
samples were positive for malaria. Overall, 127 (15.1%) neonates required admission in neonatal intensive
care unit for various morbidities. Incidence of small for gestational age (SGA) was high
(n=210; 24.9%). Multivariate logistic regression analysis demonstrated maternal malaria to be an
independent contributor for SGA [Odds Ratio (95% Confidence Interval), 10.7 (2.06 - 49.72)].
However, only 2% variance of SGA could be explained by maternal malaria alone.
Conclusion: We report an encouragingly lower incidence of maternal malaria in mothers attending
for delivery and a ‘Zero’ incidence for placental and congenital malaria during the study period as
compared to national data (upto 7.4% in non-immune mothers), although maternal malaria could
be a causative factor for SGA.
