Placental falciparum infection and outcome of pregnancy in Nigerian mothers from an endemic area

Summary

Seventy-three placentae and 73 newborn babies were examined from 72 consecutive parturient Nigerian women at term. Ten of the placentae had ring forms of Plasmodium falciparum only, 17 placentae had ring forms and schizonts, and two placentae had only schizonts. Pigment granules alone was present in two placentae, and pigment granules in combination with ring forms and/or schizonts were seen in 10 placentae. There was seasonal variation in both maternal and placental parasite infection. There was also a positive correlation between peripheral and placental parasite density. First-born babies of primigravidae with infected placentae weighed less and had body lengths lower than those of first-born babies with non-infected placentae but the difference was not statistically significant. Their weights and lengths were also significantly less than those of babies of multigravidae with infected placentae. Peripheral parasitaemia was present in 16 of 73 (21 per cent) newborn babies. Parasite density in the newborn babies was low (8–159 asexual forms per (μ blood) and only one newborn baby was symptomatic within 24 hours of birth. Infected newborn babies weighed less than non-infected newborn babies but the difference was not statistically significant. Despite peripheral and/or placental parasitaemia in 25 of the parturient women, only 5 (20 per cent) had symptoms in the one week preceding presentation. Maternal weekly pyrimethamine prophylaxis appears not to confer protection against infection.