Anthropometry of fetal growth in rural Malawi in relation to maternal malaria and HIV status


Cited By (since 1996): 3 Export Date: 1 September 2008 Source: Scopus CODEN: ADCHA doi: 10.1136/adc.2004.054650 Language of Original Document: English Correspondence Address: Brabin, B.J.; Child and Reproductive Health Group; Liverpool Sch. of Tropical Medicine; Pembroke Place Liverpool L3 5QA, United Kingdom; email: Chemicals/CAS: hemoglobin F, 9034-63-3 References: Dunn, P.M., The search for perinatal definitions and standards (1985) Acta Paediatr Scand, 319 (SUPPL.), pp. 7-16; Guemezoglu, M., De Onis, M., Villar, J., Effectiveness of interventions to prevent or treat impaired fetal growth (1997) Obstet Gynecol Survey, 52, pp. 139-149; Chu, P.W., Ecker, J.L., Feldstein, V.A., US Evaluation of fetal growth: Prediction of neonatal outcomes (2002) Radiology, 223, pp. 153-161; McIntire, D.D., Bloom, S.L., Casey, B.M., Birthweight in relation to morbidity and mortality among new born infants (1999) N Engl J Med, 340, pp. 1234-1238; Villar, J., De Onis, M., Kestler, E., The differential morbidity of the intrauterine growth retardation syndrome (1990) Am J Obstet Gynecol, 163, pp. 151-157; Forssa, E., Gissler, M., Sihvonen, M., Maternal predictors of perinatal mortality: The role of birthweight (1999) Int J Epidemiol, 28, pp. 475-478; Onis, M., Villar, J., Gulmezoglu, M., Nutritional interventions to prevent intrauterine growth retardation: Evidence from randomized controlled trials (1998) Eur J Clin Nutr, 52 (SUPPL. 1), pp. S83-93; Williams, S., St. George, I.M., Silva, P.A., Intrauterine growth retardation and blood pressure at age seven and eighteen (1992) J Clin Epidemiol, 45, pp. 1257-1263; Abdul-Karim, R.W., Beydoun, S.N., Growth of the human fetus (1974) Clin Obstet Gynecol, 17, p. 37; Babson, G.S., Behrman, R.E., Lessel, R., Liveborn birthweights for gestational age of white middle class infants (1970) Pediatrics, 45, pp. 937-944; Verhoeff, F.H., Brabin, B.J., van Buuren, S., An analysis of intra-uterine growth retardation in rural Malawi (2001) Eur J Clin Nutr, 55, pp. 682-689; (1995) Meteorological Data, 1993-1994., Nchalo; (1998) Malawi Population and Housing Census. 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European Collaborative Study (2004) AIDS, 18, pp. 344-347; Taha, T.E., Nour, S., Kumwenda, N.I., Gender differences in perinatal HIV acquisition among African infants (2004) XV International AIDS Conference, Bangkok, Thailand, July 12-16, Abstract Th Or C1 420” Objective: To describe fetal growth centiles in relation to maternal malaria and HIV status, using cross sectional measurements at birth. Design: A cross sectional study of pregnant women and their babies. Data on maternal socioeconomic status and current pregnancy, including HIV status and newborn anthropometry, were collected. Malaria parasitaemia was assessed in maternal peripheral and placental blood, fetal haemoglobin was measured in cord blood, and maternal HIV status was determined. Setting: Two district hospitals in rural southern Malawi, between March 1993 and July 1994. Outcome variables: Newborn weight, length, Rohrer’s ponderal index. Results: Maternal HIV (adjusted odds ratio (AOR) 1.76 (95\% confidence interval 1.04 to 2.98)) and first pregnancy (AOR 1.83 (1.10 to 3.05)) were independently associated with low weight for age. Placental or peripheral parasifaemia at delivery (AOR 1.73 (1.02 to 2.88)) and primigravidae (AOR 2.13 (1.27 to 3.59)) were independently associated with low length for age. Maternal malaria at delivery and primiparity were associated with reduced newborn weight and length but not with disproportionate growth. Maternal HIV infection was associated only with reduced birth weight. The malaria and parity effect occurred throughout gestational weeks 30-40, but the HIV effect primarily after 38 weeks gestation. Conclusion: Fetal growth retardation in weight and length commonly occurs in this highly malarious area and is present from 30 weeks gestation. A maternal HIV effect on fetal weight occurred after 38 weeks gestation

Archives of Disease in Childhood: Fetal and Neonatal Edition Arch.Dis.Child.Fetal Neonatal Ed., (90), 2