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(Referência obtida automaticamente do Web of Science, por meio da informação sobre o financiamento pela FAPESP e o número do processo correspondente, incluída na publicação pelos autores.)

Association of Malaria Infection During Pregnancy With Head Circumference of Newborns in the Brazilian Amazon

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Autor(es):
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Dombrowski, Jamille Gregorio [1] ; de Souza, Rodrigo Medeiros [2, 1] ; Lima, Flavia Afonso [1] ; Bandeira, Carla Leticia [1] ; Murillo, Oscar [1] ; Costa, Douglas de Sousa [1] ; Machado Peixoto, Erika Paula [1] ; Cunha, Marielton dos Passos [3] ; de Andrade Zanotto, Paolo Marinho [3] ; Bevilacqua, Estela [4] ; Grigolin Grisotto, Marcos Augusto [5] ; Pedroso de Lima, Antonio Carlos [6] ; Singer, Julio da Motta [6] ; Campino, Susana [7] ; Clark, Taane Gregory [8, 7] ; Epiphanio, Sabrina [9] ; Goncalves, Ligia Antunes [1] ; Farias Marinho, Claudio Romero [1]
Número total de Autores: 18
Afiliação do(s) autor(es):
[1] Univ Sao Paulo, Inst Biomed Sci, Dept Parasitol, Ave Prof Lineu Prestes 1374, BR-05508900 Sao Paulo - Brazil
[2] Univ Fed Acre, Multidisciplinary Ctr, Acre - Brazil
[3] Univ Sao Paulo, Inst Biomed Sci, Dept Microbiol, Sao Paulo - Brazil
[4] Univ Sao Paulo, Inst Biomed Sci, Dept Cell & Dev Biol, Sao Paulo - Brazil
[5] CEUMA Univ, Maranhao - Brazil
[6] Univ Sao Paulo, Inst Math & Stat, Dept Stat, Sao Paulo - Brazil
[7] London Sch Hyg & Trop Med, Fac Infect & Trop Dis, London - England
[8] London Sch Hyg & Trop Med, Fac Epidemiol & Populat Hlth, London - England
[9] Univ Sao Paulo, Sch Pharmaceut Sci, Dept Clin & Toxicol Anal, Sao Paulo - Brazil
Número total de Afiliações: 9
Tipo de documento: Artigo Científico
Fonte: JAMA NETWORK OPEN; v. 2, n. 5 MAY 2019.
Citações Web of Science: 0
Resumo

IMPORTANCE Malaria during pregnancy is associated with adverse events for the fetus and newborn, but the association of malaria during pregnancy with the head circumference of the newborn is unclear. OBJECTIVE To investigate the association of malaria during pregnancy with fetal head growth. DESIGN, SETTING, AND PARTICIPANTS Two cohort studies were conducted at the general maternity hospital of Cruzeiro do Sul (Acre, Brazil) in the Amazonian region. One cohort study prospectively enrolled noninfected and malaria-infected pregnant women who were followed up until delivery, between January 2013 and April 2015. The other cohort study was assembled retrospectively using clinical and malaria data from all deliveries that occurred between January 2012 and December 2013. Data analyses were conducted from January to August 2017 and revised in November 2018. Clinical data from pregnant women and anthropometric measures of their newborns were evaluated. A total of 600 pregnant women were enrolled through volunteer sampling (prospective cohort study), and 4697 pregnant women were selected by population-based sampling (retrospective cohort study). After application of exclusion criteria, data from 251 (prospective cohort study) and 232 (retrospective cohort study) malaria-infected and 158 (prospective cohort study) and 3650 (retrospective cohort study) noninfected women were evaluated. EXPOSURE Malaria during pregnancy. MAIN OUTCOMES AND MEASURES The primary end point was the incidence of altered head circumference in newborns delivered from malaria-infected mothers compared with that from noninfected mothers. Secondary end points included measures of placental pathology relative to newborn head circumference. RESULTS In total, 4291 maternal-child pairs were analyzed. Among 409 newborns in the prospective cohort study, the mothers of 251 newborns had malaria during pregnancy, infected with Plasmodium vivax, Plasmodium falciparum, or both. Among 3882 newborns in the retrospective cohort study, 232 were born from mothers that had malaria during pregnancy. The prevalence of newborns with a small head (19 {[}30.7%] in the prospective cohort study and 30 {[}36.6%] in the retrospective cohort study) and the prevalence of microcephaly among newborns (5 {[}8.1%] in the prospective cohort study and 6 {[}7.3%] in the retrospective cohort study) were higher among newborns from women infected with P falciparum during pregnancy. Multivariate logistic regression analyses revealed that P falciparum infection during pregnancy represented a significant risk factor for the occurrence of small head circumference in newborns (prospective cohort study: odds ratio, 3.15; 95% CI, 1.52-6.53; P = .002; retrospective cohort study: odds ratio, 1.91; 95% CI, 1.21-3.04; P = .006). Placental pathologic findings corroborated this association, with more syncytial nuclear aggregates and inflammatory infiltrates occurring in placentas of newborns born with decreased head circumference. CONCLUSIONS AND RELEVANCE This study indicates that falciparum malaria during pregnancy is associated with decreased head circumference in newborns, which is in turn associated with evidence of placental malaria. (AU)

Processo FAPESP: 09/53889-0 - Estudo dos mecanismos imunopatológicos envolvidos na malária durante a gravidez
Beneficiário:Cláudio Romero Farias Marinho
Linha de fomento: Auxílio à Pesquisa - Apoio a Jovens Pesquisadores
Processo FAPESP: 14/09964-5 - O papel dos inflamassomas na patogênese da malária associada à gravidez: efeitos e mecanismos
Beneficiário:Cláudio Romero Farias Marinho
Linha de fomento: Auxílio à Pesquisa - Regular
Processo FAPESP: 14/20451-0 - O papel das células endoteliais na imunopatogênese da LPA/SDRA murina associado à malária: efeitos e mecanismos
Beneficiário:Sabrina Epiphanio
Linha de fomento: Auxílio à Pesquisa - Regular
Processo FAPESP: 14/17766-9 - Abordagem sistêmica no estudo da permissividade do Anticarsia gemmatalis múltiplo nucleopoliedrovírus (AgMNPV)
Beneficiário:Paolo Marinho de Andrade Zanotto
Linha de fomento: Auxílio à Pesquisa - Regular
Processo FAPESP: 13/21728-2 - Uso de modernas técnicas de autópsia na investigação de doenças humanas (MODAU)
Beneficiário:Paulo Hilário Nascimento Saldiva
Linha de fomento: Auxílio à Pesquisa - Temático
Processo FAPESP: 16/08204-2 - Diversidade genética e filodinâmica dos arbovírus emergentes e reemergentes (DENV, ZIKV e CHIKV) nas regiões Nordeste e Sudeste do Brasil, 2014-2016
Beneficiário:Marielton dos Passos Cunha
Linha de fomento: Bolsas no Brasil - Doutorado
Processo FAPESP: 13/16417-8 - A autofagia na malária placentária: efeitos e mecanismos
Beneficiário:Flávia Afonso Lima
Linha de fomento: Bolsas no Brasil - Pós-Doutorado
Processo FAPESP: 12/04755-3 - Associação entre malária gestacional, restrição do crescimento intrauterino e baixo peso ao nascer na Amazônia Extremo-Ocidental Brasileira
Beneficiário:Jamille Gregório Dombrowski
Linha de fomento: Bolsas no Brasil - Doutorado Direto
Processo FAPESP: 15/06106-0 - O papel dos inflamassomas na patogênese da malária associada a gravidez: efeitos e mecanismos
Beneficiário:Cláudio Romero Farias Marinho
Linha de fomento: Auxílio à Pesquisa - Pesquisador Visitante - Internacional
Processo FAPESP: 13/00981-1 - Caracterização do papel das células dendríticas no recrudescimento da malária na gestação
Beneficiário:Oscar Javier Murillo Gómez
Linha de fomento: Bolsas no Brasil - Doutorado Direto
Processo FAPESP: 18/20468-0 - Recrudescimento da malária durante a gestação: efeitos e mecanismos
Beneficiário:Cláudio Romero Farias Marinho
Linha de fomento: Auxílio à Pesquisa - Regular