AUTHOR=Gaoussou Santara , Attaher Oumar , Swihart Bruce , Traore Moussa , Diarra Soumaila , Soumbounou Ibrahim H. , Ndiaye Oulematou , Issiaka Djibrilla , Morrison Robert , Mahamar Almahamoudou , Duffy Patrick E. , Dicko Alassane , Fried Michal
TITLE=Pregnancy outcomes in a malaria-exposed Malian cohort of women of child-bearing age
JOURNAL=Frontiers in Medicine
VOLUME=9
YEAR=2022
URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2022.1061538
DOI=10.3389/fmed.2022.1061538
ISSN=2296-858X
ABSTRACT=In Sub-Saharan Africa, malaria continues to be associated with adverse pregnancy outcomes including stillbirth, early neonatal death, preterm delivery, and low birth weight. Current preventive measures are insufficient and new interventions are urgently needed. However, before such interventions can be tested in pregnant women, background information on pregnancy outcomes in this target population must be collected. We conducted an observational study in Ouélessébougou, Mali, a malaria-endemic area where first antenatal visit commonly occurs during the second trimester of pregnancy, hindering calculation of miscarriage rate in the population. To accurately determine the rate of miscarriage, 799 non-pregnant women of child-bearing age were enrolled and surveyed via monthly follow up visits that included pregnancy tests. Out of 505 women that completed the study, 364 became pregnant and 358 pregnancies were analyzed: 43 (12%) resulted in miscarriage, 28 (65.1%) occurred during the first trimester of pregnancy. We also determined rates of stillbirth, neonatal death, preterm delivery, and small for gestational age. The results showed high rate of miscarriage during the first trimester and established a basis to evaluate new interventions to prevent pregnancy malaria. This survey design enabled identification of first trimester miscarriages that are often missed by studies conducted in antenatal clinics.
Clinical trial registration[https://clinicaltrials.gov/], identifier [NCT0297 4608].