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Silvio Renato Oliveira Menegassi Gabriel Ribas Pereira Eduardo Antunes Dias Celso Koetz Jr. Flávio Guiselli Lopes Carolina Bremm Concepta Pimentel Rubia Branco Lopes Marcela Kuczynski da Rocha Helena Robattini Carvalho Júlio Otavio Jardim Barcellos 《International journal of biometeorology》2016,60(1):151-157
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Jamille Gregrio Dombrowski Andr Barateiro Erika Paula Machado Peixoto Andr Boler Cludio da Silva Barros Rodrigo Medeiros de Souza Taane Gregory Clark Susana Campino Carsten Wrenger Gerhard Wunderlich Giuseppe Palmisano Sabrina Epiphanio Lígia Antunes Gonalves Claudio Romero Farias Marinho 《PLoS neglected tropical diseases》2021,15(4)
BackgroundMalaria in Brazil represents one of the highest percentages of Latin America cases, where approximately 84% of infections are attributed to Plasmodium (P.) vivax. Despite the high incidence, many aspects of gestational malaria resulting from P. vivax infections remain poorly studied. As such, we aimed to evaluate the consequences of P. vivax infections during gestation on the health of mothers and their neonates in an endemic area of the Amazon.Methods and findingsWe have conducted an observational cohort study in Brazilian Amazon between January 2013 and April 2015. 600 pregnant women were enrolled and followed until delivery. After applying exclusion criteria, 329 mother-child pairs were included in the analysis. Clinical data regarding maternal infection, newborn’s anthropometric measures, placental histopathological characteristics, and angiogenic and inflammatory factors were evaluated. The presence of plasma IgG against the P. vivax (Pv) MSP119 protein was used as marker of exposure and possible associations with pregnancy outcomes were analyzed. Multivariate logistic regression analysis revealed that P. vivax infections during the first trimester of pregnancy are associated with adverse gestational outcomes such as premature birth (adjusted odds ratio [aOR] 8.12, 95% confidence interval [95%CI] 2.69–24.54, p < 0.0001) and reduced head circumference (aOR 3.58, 95%CI 1.29–9.97, p = 0.01). Histopathology analysis showed marked differences between placentas from P. vivax-infected and non-infected pregnant women, especially regarding placental monocytes infiltrate. Placental levels of vasomodulatory factors such as angiopoietin-2 (ANG-2) and complement proteins such as C5a were also altered at delivery. Plasma levels of anti-PvMSP119 IgG in infected pregnant women were shown to be a reliable exposure marker; yet, with no association with improved pregnancy outcomes.ConclusionsThis study indicates that P. vivax malaria during the first trimester of pregnancy represents a higher likelihood of subsequent poor pregnancy outcomes associated with marked placental histologic modification and angiogenic/inflammatory imbalance. Additionally, our findings support the idea that antibodies against PvMSP119 are not protective against poor pregnancy outcomes induced by P. vivax infections. 相似文献
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