Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Oct 19;18(10):e0291172.
doi: 10.1371/journal.pone.0291172. eCollection 2023.

Placental characteristics and neonatal weights among women with malaria-preeclampsia comorbidity and healthy pregnancies

Everett Lwamulungi  1   2 , Zahida Qureshi  1   2 , Moses Obimbo  1   2   3 , Omondi Ogutu  1   2 , Eunice Cheserem  1   2 , Rose J Kosgei  1   2 , Edwin Walong  2   4 , Dennis Inyangala  2   4 , George G Nyakundi  1   2 , Patrick M Ndavi  1   2 , Alfred O Osoti  1   2 , Diana K Ondieki  1   2 , Anne N Pulei  1   2   3 , Anne Njoroge  2   5 , Sarah Masyuko  2   5 , Cyrus M Wachira  2
Affiliations

Placental characteristics and neonatal weights among women with malaria-preeclampsia comorbidity and healthy pregnancies

Everett Lwamulungi et al. PLoS One. .

Abstract

Background: Malaria and preeclampsia are leading causes of maternal morbidity and mortality in sub-Saharan Africa. They contribute significantly to poor perinatal outcomes like low neonatal weight by causing considerable placental morphological changes that impair placental function. Previous studies have described the effects of either condition on the placental structure but the structure of the placenta in malaria-preeclampsia comorbidity is largely understudied despite its high burden. This study aimed to compare the placental characteristics and neonatal weights among women with malaria-preeclampsia comorbidity versus those with healthy pregnancies.

Methodology: We conducted a retrospective cohort study among 24 women with malaria-preeclampsia comorbidity and 24 women with healthy pregnancies at a County Hospital in Western Kenya. Neonatal weights, gross and histo-morphometric placental characteristics were compared among the two groups.

Results: There was a significant reduction in neonatal weights (P<0.001), placental weights (P = 0.028), cord length (P<0.001), and cord diameter (P<0.001) among women with malaria-preeclampsia comorbidity compared to those with healthy pregnancies. There was also a significant reduction in villous maturity (P = 0.016) and villous volume density (P = 0.012) with increased villous vascularity (P<0.007) among women with malaria-preeclampsia comorbidity compared to those with healthy pregnancies.

Conclusion: Placental villous maturity and villous volume density are significantly reduced in patients with malaria-preeclampsia comorbidity with a compensatory increase in villous vascularity. This leads to impaired placental function that contributes to lower neonatal weights.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Participant selection.
Fig 2
Fig 2. Select micrographs of placentae with features of reduced villous maturity and increased vascularity.
See this image and copyright information in PMC

References

    1. Obiri D. et al. , “Histopathological lesions and exposure to Plasmodium falciparum infections in the placenta increases the risk of preeclampsia among pregnant women,” Sci. Rep., vol. 10, no. 1, pp. 1–10, 2020, doi: 10.1038/s41598-020-64736-4 - DOI - PMC - PubMed
    1. Duley L., “The Global Impact of Pre-eclampsia and Eclampsia,” Semin. Perinatol., vol. 33, no. 3, pp. 130–137, 2009, doi: 10.1053/j.semperi.2009.02.010 - DOI - PubMed
    1. Schantz-Dunn J. and Nour N. M., “Malaria and pregnancy: a global health perspective.,” Rev. Obstet. Gynecol., vol. 2, no. 3, pp. 186–192, 2009. - PMC - PubMed
    1. Medeiros de Souza R. et al. , “Correction: Placental Histopathological Changes Associated with Plasmodium vivax Infection during Pregnancy,” PLoS Negl. Trop. Dis., vol. 7, p. e2071, Feb. 2013, doi: 10.1371/journal.pntd.0002071 - DOI - PMC - PubMed
    1. Chaikitgosiyakul S. et al. , “A morphometric and histological study of placental malaria shows significant changes to villous architecture in both Plasmodium falciparum and Plasmodium vivax infection.,” Malar. J., vol. 13, p. 4, Jan. 2014, doi: 10.1186/1475-2875-13-4 - DOI - PMC - PubMed