Falciparum but not vivax malaria increases the risk of hypertensive disorders of pregnancy in women followed prospectively from the first trimester

Whitney E Harrington; Kerryn A Moore; Aung Myat Min; Mary Ellen Gilder; Nay Win Tun; Moo Kho Paw; Jacher Wiladphaingern; Stephane Proux; Kesinee Chotivanich; Marcus J Rijken; Nicholas J White; François Nosten; Rose McGready

doi:10.1186/s12916-021-01960-3

Falciparum but not vivax malaria increases the risk of hypertensive disorders of pregnancy in women followed prospectively from the first trimester

Whitney E Harrington, Kerryn A Moore, Aung Myat Min, Mary Ellen Gilder, Nay Win Tun, Moo Kho Paw, Jacher Wiladphaingern, Stephane Proux, Kesinee Chotivanich, Marcus J Rijken, Nicholas J White, François Nosten, Rose McGready

Research output: Contribution to journal › Article › Academic › peer-review

7 Downloads (Pure)

Abstract

BACKGROUND: Malaria and hypertensive disorders of pregnancy (HDoP) affect millions of pregnancies worldwide, particularly those of young, first-time mothers. Small case-control studies suggest a positive association between falciparum malaria and risk of pre-eclampsia but large prospective analyses are lacking.

METHODS: We characterized the relationship between malaria in pregnancy and the development of HDoP in a large, prospectively followed cohort. Pregnant women living along the Thailand-Myanmar border, an area of low seasonal malaria transmission, were followed at antenatal clinics between 1986 and 2016. The relationships between falciparum and vivax malaria during pregnancy and the odds of gestational hypertension, pre-eclampsia, or eclampsia were examined using logistic regression amongst all women and then stratified by gravidity.

RESULTS: There were 23,262 singleton pregnancies in women who presented during the first trimester and were followed fortnightly. Falciparum malaria was associated with gestational hypertension amongst multigravidae (adjusted odds ratio (AOR) 2.59, 95%CI 1.59-4.23), whereas amongst primigravidae, it was associated with the combined outcome of pre-eclampsia/eclampsia (AOR 2.61, 95%CI 1.01-6.79). In contrast, there was no association between vivax malaria and HDoP.

CONCLUSIONS: Falciparum but not vivax malaria during pregnancy is associated with hypertensive disorders of pregnancy.

Original language	English
Article number	98
Pages (from-to)	1-11
Number of pages	11
Journal	BMC Medicine
Volume	19
Issue number	1
DOIs	https://doi.org/10.1186/s12916-021-01960-3
Publication status	Published - 27 Apr 2021

Keywords

Falciparum malaria
First trimester
Gestational hypertension
Pre-eclampsia
Vivax malaria

Access to Document

10.1186/s12916-021-01960-3Licence: CC BY

s12916-021-01960-3Final published version, 1.83 MBLicence: CC BY

Cite this

Harrington, W. E., Moore, K. A., Min, A. M., Gilder, M. E., Tun, N. W., Paw, M. K., Wiladphaingern, J., Proux, S., Chotivanich, K., Rijken, M. J., White, N. J., Nosten, F., & McGready, R. (2021). Falciparum but not vivax malaria increases the risk of hypertensive disorders of pregnancy in women followed prospectively from the first trimester. BMC Medicine, 19(1), 1-11. Article 98. https://doi.org/10.1186/s12916-021-01960-3

@article{2c726c78bd544353b3b660a9bb8710b3,

title = "Falciparum but not vivax malaria increases the risk of hypertensive disorders of pregnancy in women followed prospectively from the first trimester",

abstract = "BACKGROUND: Malaria and hypertensive disorders of pregnancy (HDoP) affect millions of pregnancies worldwide, particularly those of young, first-time mothers. Small case-control studies suggest a positive association between falciparum malaria and risk of pre-eclampsia but large prospective analyses are lacking.METHODS: We characterized the relationship between malaria in pregnancy and the development of HDoP in a large, prospectively followed cohort. Pregnant women living along the Thailand-Myanmar border, an area of low seasonal malaria transmission, were followed at antenatal clinics between 1986 and 2016. The relationships between falciparum and vivax malaria during pregnancy and the odds of gestational hypertension, pre-eclampsia, or eclampsia were examined using logistic regression amongst all women and then stratified by gravidity.RESULTS: There were 23,262 singleton pregnancies in women who presented during the first trimester and were followed fortnightly. Falciparum malaria was associated with gestational hypertension amongst multigravidae (adjusted odds ratio (AOR) 2.59, 95%CI 1.59-4.23), whereas amongst primigravidae, it was associated with the combined outcome of pre-eclampsia/eclampsia (AOR 2.61, 95%CI 1.01-6.79). In contrast, there was no association between vivax malaria and HDoP.CONCLUSIONS: Falciparum but not vivax malaria during pregnancy is associated with hypertensive disorders of pregnancy.",

keywords = "Falciparum malaria, First trimester, Gestational hypertension, Pre-eclampsia, Vivax malaria",

author = "Harrington, {Whitney E} and Moore, {Kerryn A} and Min, {Aung Myat} and Gilder, {Mary Ellen} and Tun, {Nay Win} and Paw, {Moo Kho} and Jacher Wiladphaingern and Stephane Proux and Kesinee Chotivanich and Rijken, {Marcus J} and White, {Nicholas J} and Fran{\c c}ois Nosten and Rose McGready",

note = "Funding Information: This research was funded in part by the Wellcome-Trust Major Overseas Program in Southeast Asia [WT-106698]. For the purpose of open access, the author has applied a CC BY public copyright license to any author accepted manuscript version arising from this submission; WEH was supported by the National Institutes of Health/National Institute of Allergy and Infectious Diseases [K08 AI135072], Burroughs Wellcome Fund [CAMS 1017213], and the American Society for Tropical Medicine and Hygiene with a Benjamin H. Kean Travel Fellowship. Publisher Copyright: {\textcopyright} 2021, The Author(s).",

year = "2021",

month = apr,

day = "27",

doi = "10.1186/s12916-021-01960-3",

language = "English",

volume = "19",

pages = "1--11",

journal = "BMC Medicine",

issn = "1741-7015",

publisher = "BioMed Central Ltd.",

number = "1",

}

Harrington, WE, Moore, KA, Min, AM, Gilder, ME, Tun, NW, Paw, MK, Wiladphaingern, J, Proux, S, Chotivanich, K, Rijken, MJ, White, NJ, Nosten, F & McGready, R 2021, 'Falciparum but not vivax malaria increases the risk of hypertensive disorders of pregnancy in women followed prospectively from the first trimester', BMC Medicine, vol. 19, no. 1, 98, pp. 1-11. https://doi.org/10.1186/s12916-021-01960-3

TY - JOUR

T1 - Falciparum but not vivax malaria increases the risk of hypertensive disorders of pregnancy in women followed prospectively from the first trimester

AU - Harrington, Whitney E

AU - Moore, Kerryn A

AU - Min, Aung Myat

AU - Gilder, Mary Ellen

AU - Tun, Nay Win

AU - Paw, Moo Kho

AU - Wiladphaingern, Jacher

AU - Proux, Stephane

AU - Chotivanich, Kesinee

AU - Rijken, Marcus J

AU - White, Nicholas J

AU - Nosten, François

AU - McGready, Rose

N1 - Funding Information: This research was funded in part by the Wellcome-Trust Major Overseas Program in Southeast Asia [WT-106698]. For the purpose of open access, the author has applied a CC BY public copyright license to any author accepted manuscript version arising from this submission; WEH was supported by the National Institutes of Health/National Institute of Allergy and Infectious Diseases [K08 AI135072], Burroughs Wellcome Fund [CAMS 1017213], and the American Society for Tropical Medicine and Hygiene with a Benjamin H. Kean Travel Fellowship. Publisher Copyright: © 2021, The Author(s).

PY - 2021/4/27

Y1 - 2021/4/27

N2 - BACKGROUND: Malaria and hypertensive disorders of pregnancy (HDoP) affect millions of pregnancies worldwide, particularly those of young, first-time mothers. Small case-control studies suggest a positive association between falciparum malaria and risk of pre-eclampsia but large prospective analyses are lacking.METHODS: We characterized the relationship between malaria in pregnancy and the development of HDoP in a large, prospectively followed cohort. Pregnant women living along the Thailand-Myanmar border, an area of low seasonal malaria transmission, were followed at antenatal clinics between 1986 and 2016. The relationships between falciparum and vivax malaria during pregnancy and the odds of gestational hypertension, pre-eclampsia, or eclampsia were examined using logistic regression amongst all women and then stratified by gravidity.RESULTS: There were 23,262 singleton pregnancies in women who presented during the first trimester and were followed fortnightly. Falciparum malaria was associated with gestational hypertension amongst multigravidae (adjusted odds ratio (AOR) 2.59, 95%CI 1.59-4.23), whereas amongst primigravidae, it was associated with the combined outcome of pre-eclampsia/eclampsia (AOR 2.61, 95%CI 1.01-6.79). In contrast, there was no association between vivax malaria and HDoP.CONCLUSIONS: Falciparum but not vivax malaria during pregnancy is associated with hypertensive disorders of pregnancy.

AB - BACKGROUND: Malaria and hypertensive disorders of pregnancy (HDoP) affect millions of pregnancies worldwide, particularly those of young, first-time mothers. Small case-control studies suggest a positive association between falciparum malaria and risk of pre-eclampsia but large prospective analyses are lacking.METHODS: We characterized the relationship between malaria in pregnancy and the development of HDoP in a large, prospectively followed cohort. Pregnant women living along the Thailand-Myanmar border, an area of low seasonal malaria transmission, were followed at antenatal clinics between 1986 and 2016. The relationships between falciparum and vivax malaria during pregnancy and the odds of gestational hypertension, pre-eclampsia, or eclampsia were examined using logistic regression amongst all women and then stratified by gravidity.RESULTS: There were 23,262 singleton pregnancies in women who presented during the first trimester and were followed fortnightly. Falciparum malaria was associated with gestational hypertension amongst multigravidae (adjusted odds ratio (AOR) 2.59, 95%CI 1.59-4.23), whereas amongst primigravidae, it was associated with the combined outcome of pre-eclampsia/eclampsia (AOR 2.61, 95%CI 1.01-6.79). In contrast, there was no association between vivax malaria and HDoP.CONCLUSIONS: Falciparum but not vivax malaria during pregnancy is associated with hypertensive disorders of pregnancy.

KW - Falciparum malaria

KW - First trimester

KW - Gestational hypertension

KW - Pre-eclampsia

KW - Vivax malaria

UR - http://www.scopus.com/inward/record.url?scp=85105968783&partnerID=8YFLogxK

U2 - 10.1186/s12916-021-01960-3

DO - 10.1186/s12916-021-01960-3

M3 - Article

C2 - 33902567

SN - 1741-7015

VL - 19

SP - 1

EP - 11

JO - BMC Medicine

JF - BMC Medicine

IS - 1

M1 - 98

ER -

Falciparum but not vivax malaria increases the risk of hypertensive disorders of pregnancy in women followed prospectively from the first trimester

Abstract

Keywords

Access to Document

Other files and links

Fingerprint

Cite this