Malaria in pregnancy

Role of Nutrition Rukhsana Ahmed MBBS, MTropPaeds, PhD

Talk components

• Epidemiology of malaria in pregnancy

• Adverse outcome of malaria in pregnancy

• Maternal nutrition and impact

• Link between maternal nutrition and adverse pregnancy outcome

Adverse effect of malaria in pregnancy

Mother:

Anaemia

Severe disease

Baby:

Low birth weight

Premature delivery

Malaria in pregnancy:

Asymptomatic infection

Nutrient transport

Placental sequestration

Low birth weight

Risk of infant mortality

P. falciparum malaria

Anemia

Acquired immunity - high

1st & 2nd pregnancies at

greatest risk

Prevention essential

Parasite in pregnant woman

Nutritional link with malaria

Infects

humans

Chronic effects

Anaemia

Neurological/

cognitive

developmental

malnutrition Impaired

growth

pregnancy

fetus Low birth

weight

Infant

mortality

maternal anaemia Impaired

productivity

8

Neonatal 42%

HIV/AIDS 1%

Diarrhoea 19%

Measles 1%

Injuries, 3%

Other, 19%

Malaria

1%Pneumonia

15%

>35%

attributable to

undernutrition

Globally >35% of under-five deaths are attributable to undernutrition

1

Source: WHO

Consequences of Maternal Undernutrition

Maternal consequences

Child consequences

Increased risk of maternal death

Increased infections

Anaemia

Compromised immune functions

Lethargy and weakness

Lower productivity

Lactational failure

Increased risk of foetal and neonatal

deaths

Intrauterine growth retardation

Low birth weight

Pre-term birth

Compromised immune functions

Birth defects

Cretinism and reduced IQ

Source: UNICEF, 2006

1

Maternal health and undernutrition: consequences

• Poor maternal health

• Inadequate diet before and during pregnancy

• Lack of micronutrient supplementation

• Subsequent multiple pregnancies

Poor intrauterine

growth

& low birth weight

Sub-optimal child growth and development, impaired

cognition, chronic diseases in adulthood

Ways to improve maternal nutrition in pregnancy

• Increase food intake

• Take iron and folic acid supplementation

• Use iodized salts

• Take other micronutrients/vitamin A after delivery

• Reduce workload

• Management of malaria and other parasites

Malaria control in pregnancy

• Prompt management of symptomatic cases

• Sleep under insecticide treated bednet

• Screening and treat for malaria

• Repeated screening for malaria at every antenatal visit

• Intermittent treatment and prevention therapy

Thank you