Effect of Maternal HIV and Malaria Infection on Pregnancy and Perinatal Outcome in Zimbabwe

Ticconi, Carlo; Mapfumo, Monica; Dorrucci, Maria; Naha, N; Tarira, Elizabeth; Pietropolli, Adalgisa; Rezza, Giovanni

doi:10.1097/00126334-200311010-00005

Cited by 99 publications

(83 citation statements)

References 21 publications

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“…[37][38][39] Paritys specific immunity appears to be reduced in HIVspositive women; women of all parities have a higher relative risk for malaria if they are HIVspositive. 27,37,39,40 This in turn may lead to an even higher rate of adverse pregnancy outcomes, als s though we did not observe this, with the exception of a univariate effect of HIV on stillbirth. Any effect on pregnancy outcome may be partially mediated through the effect of HIV infection on malaria and/or anaemia.…”

Section: Discussioncontrasting

confidence: 62%

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Adverse birth outcomes in United Republic of Tanzania - impact and prevention of maternal risk factors

Watson-Jones

Weiss

Changalucha

et al. 2007

Bull World Health Organ

130

121

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Objective To determine risk factors for poor birth outcome and their population attributable fractions. Methods 1688 women who attended for antenatal care were recruited into a prospective study of the effectiveness of syphilis screening and treatment. All women were screened and treated for syphilis and other reproductive tract infections (RTIs) during pregnancy and followed to delivery to measure the incidence of stillbirth, intrauterine growth retardation (IUGR), low birth weight (LBW) and preterm live birth. Findings At delivery, 2.7% of 1536 women experienced a stillbirth, 12% of live births were preterm and 8% were LBW. Stillbirth was independently associated with a past history of stillbirth, short maternal stature and anaemia. LBW was associated with short maternal stature, ethnicity, occupation, gravidity and maternal malaria whereas preterm birth was associated with occupation, age of sexual debut, untreated bacterial vaginosis and maternal malaria. IUGR was associated with gravidity, maternal malaria, short stature, and delivering a female infant. In the women who had been screened and treated for syphilis, in between 20 and 34% of women with each outcome was estimated to be attributable to malaria, and 63% of stillbirths were estimated as being attributable to maternal anaemia. Screening and treatment of RTIs was effective and no association was seen between treated RTIs and adverse pregnancy outcomes. Conclusion Maternal malaria and anaemia continue to be significant causes of adverse pregnancy outcome in sub-Saharan Africa. Providing reproductive health services that include treatment of RTIs and prevention of malaria and maternal anaemia to reduce adverse birth outcomes remains a priority. Voir page 16 le résumé en français. En la página 16 figura un resumen en español.

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Section: Discussioncontrasting

confidence: 62%

“…7,13,27 However, in many African populations without access to screening, maternal syphilis will remain the most important preventable cause of stillbirth. 7 Efforts to screen and treat for this infection must be a priority.…”

Section: Discussionmentioning

confidence: 99%

Adverse birth outcomes in United Republic of Tanzania - impact and prevention of maternal risk factors

Watson-Jones

Weiss

Changalucha

et al. 2007

Bull World Health Organ

130

121

View full text Add to dashboard Cite

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“…This was consistent with studies that showed increased susceptibility of HIV positive pregnant women to malaria compared to HIV negative [11,12].…”

Section: Discussionsupporting

confidence: 92%

A Study of the Outcomes of 103 Pregnant Women Admitted with Malaria at Three District Hospitals in Mashonaland East Province and One Central Hospital in Harare Province in Zimbabwe

2016

ARC Journal of Nursing and Healthcare

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“…There are many maternal conditions potentially associated with stillbirth. Some, such as hypertension and diabetes, are important in all countries, whereas others are context specifi c; for example, high prevalence of syphilis, malaria, or HIV infection 69,70 or maternal undernutrition in low-income countries and obesity or smoking in middle-income and high-income countries. 14 Other risk factors such as female literacy and socioeconomic status are also important and are discussed in other papers in this Series.…”

Section: The Importance Of Maternal Conditions For Stillbirths and Nementioning

confidence: 99%

Stillbirths: Where? When? Why? How to make the data count?

et al. 2011

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for The Lancet's Stillbirths Series steering committee* Despite increasing attention and investment for maternal, neonatal, and child health, stillbirths remain invisible-not counted in the Millennium Development Goals, nor tracked by the UN, nor in the Global Burden of Disease metrics. At least 2·65 million stillbirths (uncertainty range 2·08 million to 3·79 million) were estimated worldwide in 2008 (≥1000 g birthweight or ≥28 weeks of gestation). 98% of stillbirths occur in low-income and middle-income countries, and numbers vary from 2·0 per 1000 total births in Finland to more than 40 per 1000 total births in Nigeria and Pakistan. Worldwide, 67% of stillbirths occur in rural families, 55% in rural sub-Saharan Africa and south Asia, where skilled birth attendance and caesarean sections are much lower than that for urban births. In total, an estimated 1·19 million (range 0·82 million to 1·97 million) intrapartum stillbirths occur yearly. Most intrapartum stillbirths are associated with obstetric emergencies, whereas antepartum stillbirths are associated with maternal infections and fetal growth restriction. National estimates of causes of stillbirths are scarce, and multiple (>35) classifi cation systems impede international comparison. Immediate data improvements are feasible through household surveys and facility audit, and improvements in vital registration, including specifi c perinatal certifi cates and revised International Classifi cation of Disease codes, are needed. A simple, programme-relevant stillbirth classifi cation that can be used with verbal autopsy would provide a basis for comparable national estimates. A new focus on all deaths around the time of birth is crucial to inform programmatic investment. Why don't stillbirths count?Stillbirths are invisible in many societies and on the worldwide policy agenda, but are very real to families who experience a death. Despite 30 years of attention to child survival interventions, 1,2 more than 20 years of attention to safe motherhood, 3,4 and increasing recent attention to survival of newborn babies, 5-7 the focus worldwide has remained on survival after livebirth. Stillbirths remain mostly ignored, not counting on policy, programme, and investment agendas, both internationally and often also at the national level. 8 The importance of neonatal deaths has risen on the worldwide policy agenda, mainly because of the Millennium Development Goals (MDGs) and recognition of the increasing proportion of child deaths that happen in the fi rst month of life-from 37% in 2000 7 to 41% in 2008. 9 A baby who dies just after birth counts in the MDG tracking, but a baby who dies in the third trimester or even during labour does not. Neither the MDGs nor the Global Burden of Disease metrics mention stillbirths, and stillbirth data are not routinely compiled by the UN. Even when stillbirths are recorded in surveys, the data are frequently combined with early neonatal deaths and reported as perinatal mortality, a combination that reduces visibility and might mask reporti...

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Effect of Maternal HIV and Malaria Infection on Pregnancy and Perinatal Outcome in Zimbabwe

Abstract: Women with single HIV or malaria infection have a significantly increased risk of adverse outcomes of pregnancy and childbirth. Dual infection has additional detrimental effects on maternal and infant survival in an area where HIV and malaria coexist.

Cited by 99 publications

References 21 publications

Adverse birth outcomes in United Republic of Tanzania - impact and prevention of maternal risk factors

Adverse birth outcomes in United Republic of Tanzania - impact and prevention of maternal risk factors

A Study of the Outcomes of 103 Pregnant Women Admitted with Malaria at Three District Hospitals in Mashonaland East Province and One Central Hospital in Harare Province in Zimbabwe

Stillbirths: Where? When? Why? How to make the data count?

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