Predictors of fetal anemia and cord blood malaria parasitemia among newborns of HIV-positive mothers

• Type of Material: Article
• Authors: Amos K Laar, University of Ghana; Fredrick E Grant, Mama SASHA Project; O Yaw Addo, Emory University; Ireneous Soyiri, University of Ghana; Bright Nkansah, Nii Boi Town; James Abugri, University for Development Studies Ghana; Alexander S Laar, Project Fives Alive National Catholic Health Service; William K Ampofo, University of Ghana; Juliette M Tuakli, University of Ghana; Isabella A Quakyi, University of Ghana
• Language: English
• Date: 2013-09-06
• Publisher: BioMed Central
• Publication Version: Final Published Version
• Copyright Statement: © 2013 Laar et al.; licensee BioMed Central Ltd.
• License: Creative Commons Attribution 2.0 Generic
• Final Published Version (URL): http://dx.doi.org/10.1186/1756-0500-6-350
• Title of Journal or Parent Work: BMC Research Notes
• ISSN: 1756-0500
• Volume: 6
• Issue: 1
• Start Page: 350
• End Page: 350
• Grant/Funding Information: The entire cost of the field work was catered for by the TALIF Project # CHSR/001/2005 of the School of Public Health, College of Health Sciences, University of Ghana, Legon.
• Keywords: Male; Anemia; Infectious Disease Transmission, Vertical; Parasitemia; Infant; Malaria, Falciparum; Ghana; Coinfection; HIV Infections; Pregnancy Outcome; Humans; Fetal Hemoglobin; Sex Factors; Adult; Female; Pregnancy; Pregnancy Complications, Parasitic; Adolescent; Fetal Blood; Prevalence; Infant, Newborn
• Research Categories: Health Sciences, Public Health

Abstract

Background: Malaria and HIV infections during pregnancy can individually or jointly unleash or confound pregnancy outcomes. Two of the probable outcomes are fetal anemia and cord blood malaria parasitemia. We determined clinical and demographic factors associated with fetal anemia and cord blood malaria parasitemia in newborns of HIV-positive women from two districts in Ghana. Results: We enrolled 1,154 antenatal attendees (443 HIV-positive and 711 HIV-negative) of which 66% were prospectively followed up at delivery. Maternal malaria parasitemia, and anemia rates among HIV+ participants at enrolment were 20.3% and 78.7% respectively, and 12.8% and 51.6% among HIV- participants. Multivariate linear and logistic regression models were used to study associations. Prevalence of fetal anemia (cord hemoglobin level < 12.5 g/dL) and cord parasitemia (presence of P. falciparum in cord blood at delivery) were 57.3% and 24.4% respectively. Factors found to be associated with fetal anemia were maternal malaria parasitemia and maternal anemia. Infant cord hemoglobin status at delivery was positively and significantly associated with maternal hemoglobin and gestational age whilst female gender of infant was negatively associated with cord hemoglobin status. Maternal malaria parasitemia status at recruitment and female gender of infant were positively associated with infant cord malaria parasitemia status. Conclusions: Our data show that newborns of women infected with HIV and/or malaria are at increased risk of anemia and also cord blood malaria parasitemia. Prevention of malaria infection during pregnancy may reduce the incidence of both adverse perinatal outcomes.