PLoS Medicine (Aug 2017)

Malaria, malnutrition, and birthweight: A meta-analysis using individual participant data.

  • Jordan E Cates,
  • Holger W Unger,
  • Valerie Briand,
  • Nadine Fievet,
  • Innocent Valea,
  • Halidou Tinto,
  • Halidou Tinto,
  • Umberto D'Alessandro,
  • Sarah H Landis,
  • Seth Adu-Afarwuah,
  • Kathryn G Dewey,
  • Feiko O Ter Kuile,
  • Meghna Desai,
  • Stephanie Dellicour,
  • Peter Ouma,
  • Julie Gutman,
  • Martina Oneko,
  • Laurence Slutsker,
  • Dianne J Terlouw,
  • Simon Kariuki,
  • John Ayisi,
  • Mwayiwawo Madanitsa,
  • Victor Mwapasa,
  • Per Ashorn,
  • Kenneth Maleta,
  • Ivo Mueller,
  • Danielle Stanisic,
  • Christentze Schmiegelow,
  • John P A Lusingu,
  • Anna Maria van Eijk,
  • Melissa Bauserman,
  • Linda Adair,
  • Stephen R Cole,
  • Daniel Westreich,
  • Steven Meshnick,
  • Stephen Rogerson

DOI
https://doi.org/10.1371/journal.pmed.1002373
Journal volume & issue
Vol. 14, no. 8
p. e1002373

Abstract

Read online

BackgroundFour studies previously indicated that the effect of malaria infection during pregnancy on the risk of low birthweight (LBW; Methods and findingsWe evaluated the interaction between maternal malaria infection and maternal anthropometric status on the risk of LBW using pooled data from 14,633 pregnancies from 13 studies (6 cohort studies and 7 randomized controlled trials) conducted in Africa and the Western Pacific from 1996-2015. Studies were identified by the Maternal Malaria and Malnutrition (M3) initiative using a convenience sampling approach and were eligible for pooling given adequate ethical approval and availability of essential variables. Study-specific adjusted effect estimates were calculated using inverse probability of treatment-weighted linear and log-binomial regression models and pooled using a random-effects model. The adjusted risk of delivering a baby with LBW was 8.8% among women with malaria infection at antenatal enrollment compared to 7.7% among uninfected women (adjusted risk ratio [aRR] 1.14 [95% confidence interval (CI): 0.91, 1.42]; N = 13,613), 10.5% among women with malaria infection at delivery compared to 7.9% among uninfected women (aRR 1.32 [95% CI: 1.08, 1.62]; N = 11,826), and 15.3% among women with low mid-upper arm circumference (MUAC ConclusionsPregnant women with malnutrition and malaria infection are at increased risk of LBW compared to women with only 1 risk factor or none, but malaria and malnutrition do not act synergistically.