<i>Plasmodium falciparum</i> malaria in pregnancy: a review

Nathwani, Dilip; Currie, Peter; Douglas, J. G.; Green, Stephen T; Smith, Norman C.

doi:10.1111/j.1471-0528.1992.tb14467.x

Cited by 30 publications

(9 citation statements)

References 23 publications

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“…[7][8][9] Although some of the results from this study demonstrate patterns that have not been described in humans, these patterns may not have become apparent because of an inability to conduct a controlled experiment. In the monkey model we can time the inoculation, withhold therapeutic intervention, and there are no socioeconomic factors or other disease processes to influence outcome.…”

Section: P Coatneyimentioning

confidence: 53%

“…Malaria during pregnancy leads to complications in these monkeys and their infants, which are similar to those observed in humans. [7][8][9] These include anemia, abortion, IUGR, LBW, congenital infection, and perinatal and maternal mortality. The monkey model also demonstrated the worst outcomes in primigravidas and secundigravidas, as have been reported in human studies.…”

Section: P Coatneyimentioning

confidence: 99%

“…[1][2][3][4][5][6] Malaria during pregnancy leads to many complications in women and their infants including anemia, high fever, hypoglycemia, pulmonary edema, renal failure, cerebral malaria, abortion, preterm delivery, intrauterine growth retardation (IUGR), low birth weight (LBW), congenital infection, and increased fetal and maternal mortality. [7][8][9] The risks of symptomatic maternal malaria, maternal complications during pregnancy, and fetal compromise are influenced by the level of malaria endemicity (greater in nonendemic areas), by parity (primigravidas and secundigravidas are more susceptible than multigravidas), 8 and gestational age (prevalence of infection and parasite density are highest in the first half of the pregnancy). 10,11 Although a number of investigators have studied malaria during human pregnancy, the results are often difficult to interpret because of the confounding variables inherent in these studies 12 such as the mother's health, imprecise estimates of gestational age, tissue availability, patient compliance, socioeconomic conditions, and moral, ethical, and financial constraints.…”

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confidence: 99%

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Plasmodium coatneyi in the rhesus monkey (Macaca mulatta) as a model of malaria in pregnancy.

Davison¹,

Cogswell²,

Baskin³

et al. 1998

The American Journal of Tropical Medicine and Hygiene

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Abstract. Pregnant women with Plasmodium falciparum infection are at increased risk for complications such as anemia and cerebral malaria. In addition, the infants of these women suffer intrauterine growth retardation (IUGR), low birth weight (LBW), congenital infection, and high infant mortality. Although much has been learned from studies of malaria during human pregnancy, progress has been limited by the lack of a suitable animal model. Nonhuman primates are of particular interest because, other than the armadillo, they are the only animals with a discoidal, villous, hemochorial placenta like that of humans. We have established a model of malaria during human pregnancy by inoculating pregnant rhesus monkeys (Macaca mulatta) with Plasmodium coatneyi (a sequestering parasite) during the first trimester. In our initial experiment, four monkeys were inoculated with a fresh inoculum containing 10 8 viable parasites from an infected donor monkey. All four monkeys became parasitemic seven days postinoculation (PI) and three monkeys aborted 7-10 days PI coincident with high peak parasitemias (41,088-374,325 parasites/mm 3 ). Although abortion is one of the outcomes observed in Plasmodium-infected women, the intent of this study was to examine the effects of Plasmodium infection throughout gestation. Since the rapid onset of high parasitemia may have been responsible for the abortions, a decision was made to reduce the size of the effective inoculum. Six additional pregnant monkeys were inoculated with a frozen isolate taken from the same donor containing 10 6 parasites. These six animals became parasitemic by 14 days PI and, along with monkey E412, carried their infants to term. These seven infants weighed significantly less at term than the infants of uninfected mothers (P ϭ 0.0355). Symmetrical IUGR was detected by ultrasound in one fetus with an LBW of 334 g. Another LBW infant (300 g) had asymmetrical growth retardation, which has been associated with uteroplacental insufficiency and was consistent with the lower placental weights found in infected dams compared with controls (P ϭ 0.0455). The infant with symmetric IUGR died at five days of age, while the other is alive but congenitally infected. The IUGR, LBW, congenital infection, postnatal infant mortality, and early abortions observed in these animals suggest that P. coatneyi in pregnant rhesus monkeys is a valid model of malaria in human pregnancy. This model should provide the opportunity to study questions about malaria in pregnancy that have been difficult to study in humans.Pregnant women are more likely to develop symptomatic malaria than their nonpregnant counterparts.

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Section: P Coatneyimentioning

confidence: 53%

Section: P Coatneyimentioning

confidence: 99%

mentioning

confidence: 99%

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Plasmodium coatneyi in the rhesus monkey (Macaca mulatta) as a model of malaria in pregnancy.

Davison¹,

Cogswell²,

Baskin³

et al. 1998

The American Journal of Tropical Medicine and Hygiene

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“…[1][2][3][4][5] We have recently established that the pregnant rhesus monkey inoculated with P. coatneyi is an excellent animal model of this disease process, demonstrating these same adverse fetal/infant outcomes. 6 Examination of the placenta is essential to explaining abnormal fetal and neonatal outcome.…”

Section: Introductionmentioning

confidence: 96%

Placental changes associated with fetal outcome in the Plasmodium coatneyi/rhesus monkey model of malaria in pregnancy.

Davison

Cogswell²,

Baskin³

et al. 2000

The American Journal of Tropical Medicine and Hygiene

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Abstract. Term placentas collected surgically from seven Plasmodium coatneyi-infected rhesus monkeys, one abortion, and five controls were evaluated histopathologically. The placentas from Plasmodium-infected dams had more significant pathologic changes than those from controls for six parameters (P Ͻ 0.05) and higher numbers of activated (LN5 ϩ Zymed) macrophages in the intervillous space (IVS) (P ϭ 0.0173). Total parasite load (TPL) was defined as the sum of all weekly peripheral infected red blood cell counts for each trimester and for the entire pregnancy. High first trimester PLs were more likely to result in fetal demise (P ϭ 0.0476) or increased placental damage in surviving infants. As trimester 2-3 TPL increased, so did the number of activated macrophages (P Ͻ 0.05) and the total malaria pigment scores (P Ͻ 0.05). Low birth weight (LBW) and intrauterine growth retardation (IUGR) were associated with high pigment scores and high numbers of activated macrophages in the IVS. High placental damage scores were not associated with IUGR, LBW, or early infant mortality.

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“…5 Among semi-immune women, severe syndromes such as cerebral malaria and pulmonary oedema frequently occur. 6 Maternal malaria is associated with poor foetal outcomes such as stillbirths, abortions and low birth weight infants which are at a higher risk of dying early in life. 7 Human placenta has a predilection for malaria parasites and since maternal and foetal tissues within the placenta are intimately associated, parasite antigens can cross the placental barrier and influence the immune response of the foetus.…”

Section: Introductionmentioning

confidence: 99%

Studies on Plasmodium falciparum isotypic antibodies and numbers of IL-4 and IFN-γ secreting cells in paired maternal cord blood from South West Cameroon

Achidi

Anchang

Minang

et al. 2005

International Journal of Infectious Diseases

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Plasmodium falciparum malaria in pregnancy: a review

Cited by 30 publications

References 23 publications

Plasmodium coatneyi in the rhesus monkey (Macaca mulatta) as a model of malaria in pregnancy.

Plasmodium coatneyi in the rhesus monkey (Macaca mulatta) as a model of malaria in pregnancy.

Placental changes associated with fetal outcome in the Plasmodium coatneyi/rhesus monkey model of malaria in pregnancy.

Studies on Plasmodium falciparum isotypic antibodies and numbers of IL-4 and IFN-γ secreting cells in paired maternal cord blood from South West Cameroon

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