Placental malaria and low birth weight in pregnant women living in a rural area of Burkina Faso following the use of three preventive treatment regimens

Pregnant women attending the first antenatal care visit were randomly assigned to one of the three treatment regimens. They were subsequently followed up till delivery. Maternal, placental and cord blood samples were obtained upon delivery to check for P. falciparum infection.A total of 648 pregnant women were enrolled in the study. Delivery outcome were available for 423 of them. Peripheral maternal P. falciparum infection at delivery was found in 25.8% of the women. The proportion of women with maternal infection was significantly lower in the IPTp/SP group than in the CQ group (P << 0.000). The prevalence of placental malaria was 18.8% in the CWC/CQ group; 15.9% in the IPTp/CQ group and 10.6% in the IPTp/SP group. The incidence of LBW (weigth < 2,500 g) was significantly higher among infants of mothers in the CWC/CQ group (23.9%) as compared with those of mothers in the IPTp/CQ (15.6%) and IPTp/SP (11.6%) groups (p = 0.02)Intermittent preventive treatment with SP has shown clear superiority in reducing adverse outcomes at delivery, as compared with intermittent preventive treatment with CQ and classical chemoprophylaxis with CQ.In malaria endemic countries, pregnant women, along with children under five years, represent the most vulnerable group to Plasmodium falciparum infection [1,2]. Such infection often increases the risk of morbidity and mortality for the mother and her child. Indeed, in malaria stable transmission conditions, it has been shown that pregnancy associated with malaria increases the risk of maternal anaemia, stillbirths and low birth weight (LBW) [3,4]. Over 26% of anaemia in pregnancy is attributable to malaria, and malaria-related maternal deaths are reaching an unacceptable rate of 23%[5]. These adverse outcomes have been described as the consequences of placental sequestration of P. falciparum. In addition, because of this sequestration, peripheral blood film microscopy usually underestimates the prevalence of placental malaria [6,7].In are