Comparative Study on Antenatal and Perinatal Outcome of Vivax and Falciparum Malaria in a Tertiary Care Hospital of Kolkata, India

Abstract

Introduction: Malaria occurring in pregnancy is associated with considerable maternal and perinatal morbidity. In India, the problem is compounded by dual parasitological aetiology of Plasmodiumvivax (P.vivax) and Plasmodium falciparum (P.falciparum).

Aim: To compare the outcome of infections by P. vivax and P.falciparum species among pregnant women in a hospital setting.

Materials and methods: Pregnant women who tested positive for malaria either by microscopy of peripheral blood smear or ELISA test for double antigen were enrolled in the study. They were followed up till their delivery and discharge from hospital. Demographic, clinical and laboratory data was collected at enrolment, on event of complication and at delivery. Data was analyzed for univariate and multivariate associations.

Results: There were 64 pregnant women diagnosed with malaria. A total of 76.6% study subjects had vivax infection rest were infected with p. falciparum. Anaemia (84%) was the commonest complication. A total of 60.9% women had pathological placenta. Preterm delivery, low birth weight and Apgar score <7 were the adverse pregnancy outcomes which were more frequent with falciparum infection. There were three perinatal deaths. Multigravidas were at significantly higher risk for low birth weight and low Apgar score of newborn. Infection in later trimester was associated with low Apgar score.

Conclusion: Both types of malaria cause considerable morbidity in pregnant women. More cases occurred among primigravida but multigravida and later trimester of pregnancy had more severe disease.

Keywords: Anaemia; Apgar score; Malaria control; Malaria epidemiology; Malaria falciparum; Malaria pigment; Malaria vivax; Parasitic; Pregnancy complications.