Malaria in Early Pregnancy and the Development of the Placental Vasculature
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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Malaria in Early Pregnancy and the Development of the Placental Vasculature. / Moeller, Sofie L.; Nyengaard, Jens R.; Larsen, Lise G.; Nielsen, Karsten; Bygbjerg, Ib C.; Msemo, Omari A.; Lusingu, John P.A.; Minja, Daniel T.R.; Theander, Thor G.; Schmiegelow, Christentze.
I: The Journal of Infectious Diseases, Bind 220, Nr. 9, 26.09.2019, s. 1425-1434.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Malaria in Early Pregnancy and the Development of the Placental Vasculature
AU - Moeller, Sofie L.
AU - Nyengaard, Jens R.
AU - Larsen, Lise G.
AU - Nielsen, Karsten
AU - Bygbjerg, Ib C.
AU - Msemo, Omari A.
AU - Lusingu, John P.A.
AU - Minja, Daniel T.R.
AU - Theander, Thor G.
AU - Schmiegelow, Christentze
PY - 2019/9/26
Y1 - 2019/9/26
N2 - BACKGROUND: Pregnancy malaria has a negative impact on fetal outcome. It is uncertain whether infections in early pregnancy have a clinical impact by impeding the development of the placental vasculature. METHODS: Tanzanian women (n = 138) were closely monitored during pregnancy. Placentas collected at birth were investigated using stereology to establish the characteristics of placental villi and vessels. Placental vasculature measures were compared between women infected with malaria and controls. RESULTS: Compared with controls, placentas from women infected with malaria before a gestational age (GA) of 15 weeks had a decreased volume of transport villi (mean decrease [standard deviation], 12.45 [5.39] cm3; P = .02), an increased diffusion distance in diffusion vessels (mean increase, 3.33 [1.27] µm; P = .01), and a compensatory increase in diffusion vessel surface area (mean increase, 1.81 [0.74 m2]; P = .02). In women who had malaria before a GA of 15 weeks diffusion vessel surface area and transport vessel length distance were positive predictors for birth weight (multilinear regression: P = .007 and P = .055 for diffusion surface area and transport length, respectively) and GA at delivery (P = .005 and P = .04). CONCLUSIONS: Malaria infection in early pregnancy impedes placental vascular development. The resulting phenotypic changes, which can be detected at delivery, are associated with birth weight and gestational length. CLINICAL TRIALS REGISTRATION: NCT02191683.
AB - BACKGROUND: Pregnancy malaria has a negative impact on fetal outcome. It is uncertain whether infections in early pregnancy have a clinical impact by impeding the development of the placental vasculature. METHODS: Tanzanian women (n = 138) were closely monitored during pregnancy. Placentas collected at birth were investigated using stereology to establish the characteristics of placental villi and vessels. Placental vasculature measures were compared between women infected with malaria and controls. RESULTS: Compared with controls, placentas from women infected with malaria before a gestational age (GA) of 15 weeks had a decreased volume of transport villi (mean decrease [standard deviation], 12.45 [5.39] cm3; P = .02), an increased diffusion distance in diffusion vessels (mean increase, 3.33 [1.27] µm; P = .01), and a compensatory increase in diffusion vessel surface area (mean increase, 1.81 [0.74 m2]; P = .02). In women who had malaria before a GA of 15 weeks diffusion vessel surface area and transport vessel length distance were positive predictors for birth weight (multilinear regression: P = .007 and P = .055 for diffusion surface area and transport length, respectively) and GA at delivery (P = .005 and P = .04). CONCLUSIONS: Malaria infection in early pregnancy impedes placental vascular development. The resulting phenotypic changes, which can be detected at delivery, are associated with birth weight and gestational length. CLINICAL TRIALS REGISTRATION: NCT02191683.
KW - Malaria
KW - placenta
KW - pregnancy
KW - stereology
KW - Tanzania
KW - vascularization
U2 - 10.1093/infdis/jiy735
DO - 10.1093/infdis/jiy735
M3 - Journal article
C2 - 30590576
VL - 220
SP - 1425
EP - 1434
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
SN - 0022-1899
IS - 9
ER -
ID: 228896260