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
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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
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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
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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