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Table 1 Ultrasound-dated preterm birth prevalence and mean gestational age in malaria endemic and non-endemic areas

From: Testing an infection model to explain excess risk of preterm birth with long-term iron supplementation in a malaria endemic area

Country

Study years

Study designa

Ageb

N

Parity

Mean gestational age (days)

Preterm birthc (%)

Malaria exposure

References

Malawi

Pre 2009

PRCT

≤ 20–≥ 40

2149

All

270.2

16.3

29.5d

[92]

Pre 2005

Cohort

22.8

456

All

266

20.3

NR

[97]

Mali

2010–2013

Cohort

15–45

152

PG

268.8

16.4

15.8e

[3]

–

 

–

114

SG

271.5

12.3

10.5e

–

 

–

325

MG

275.8

2.5

9.5e

Kenya

 Control

2011–2013

PRCT

15–45

233

All

271

16.2

52.1f

[93]

 Iron supplement

–

  

237

All

274.4

9.1

50.9

Gambia

 Control

2006–2008

Peri-RCT

28.9

150

All

282.1

5.3

1.3g

[98]

 Multinutrients

  

–

139

All

280

0.7

0.9

Benin

2008–2011

Cohort

NR

814

All

NR

9.9

34.2h

[84]

Tanzania

2008–2010

Cohort

22

28

PG,SG

272.7

NR

All exposedi

[83]

–

–

23

93

PG,SG

279.4

NR

None exposedi

Uganda

2014

Nested PRCT

22.1

282

All

NR

9.2

2.9 to 8.6j

[94]

Papua New Guinea

2009–2012

PRCT

24.5

1941

All

274

8.6

13.6k

[95]

Burkina Faso (PALUFER)

 Control

2011–2013

Peri-RCT

17.1

137

PG

269

13.9

29.3l

[2]

 Iron supplemented

–

–

–

149

PG

264

27.5

37.1l

34 high-income countries

1996–2010

Mixed

NR

9.1 × 106

All

275.5

4.6–8.2

None

[96]

  1. PG primigravidae, SG secundigravidae; multigravidae, N sample size, NR Not reported, PRCT pregnancy randomized control trial, Peri-RCT periconceptional randomized control trial
  2. aProvision of antenatal iron supplements stated for Malawi, Kenya (intervention arm alone), Gambia, Burkina Faso (both trial arms after first antenatal visit). Not stated for other studies or malaria non-endemic areas
  3. bMean, median, or range in years
  4. cBirth less than 37 weeks
  5. dAntenatal parasite prevalence from thick blood film on peripheral blood at booking and second antenatal visit
  6. eParasite prevalence in peripheral blood or placental blood smear
  7. fPrevalence estimate from at least one positive result for dipstick tests (HRP2 or pLDH for any Plasmodium species) in maternal venous or placental blood, or by P. falciparum—specific PCR tests in maternal erythrocytes from venous or placental blood, or presence of parasites or pigment in placental biopsies by histopathology. Malaria estimates include past infections in pregnancy
  8. gMalaria parasitaemia prevalence at enrolment in placebo cohort; sample size n = 240 (control), n = 232 (micronutrients)
  9. hSub-microscopic prevalence at delivery on capillary venous blood with Real-time PCR Assay for detection of P. falciparum infections
  10. iExposed or not exposed to malaria early in pregnancy
  11. jPrevalence by microscopy of placental blood smear (2.9%); prevalence of parasite DNA in placental blood (8.6%), and histopathologic detection of malaria infection (pigment or parasites) of placental biopsies, which includes past infection (37.2%)
  12. kPeripheral parasitaemia prevalence at enrolment by light microscopy and/or real time polymerase chain reaction (P. falciparum, P. vivax)
  13. lAcute and chronic placental malaria prevalence (presence of parasitized cells on histology). Sample size at delivery n = 89 (iron supplements, n = 92 (control))
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Malaria Journal

ISSN: 1475-2875

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