Placental Malaria and Pre-Eclampsia from the Lagos State University Teaching Hospital, Ikeja, Lagos Nigeria

Abstract

Objective: To determine the relationship between placental malaria infection and pre-eclampsia in a holo-endemic zone. Design: Prospective case-control study. Materials and Methods: One hundred and twenty seven (127) pregnant women with a diagnosis of pre-eclampsia in labour or having caesarean section served as cases while controls were 127 normotensive parturient women. They were recruited from the maternity unit of Ifako Ijaiye and Isolo General Hospitals, Lagos that served as secondary care centers. At delivery, either spontaneous vaginal delivery or by caesarean section, a 2.0 cm × 2.0 cm placenta tissue was cut with scalpel and fixed in 10% formaldehyde in a specimen bottle and sent to the pathologist. Following this, 2.5 mls of Cord blood and 2.5 mls of the maternal venous blood were taken into separate EDTA bottles properly labeled at delivery, samples were sent to the haematology laboratory immediately for peripheral thick film smear for malaria parasite. Results were obtained from the laboratory and together with data from the case files, they were entered into SPSS version 16 for analysis. Independent Student t-test was used for significance for continuous variables while Chi-square was used for qualitative data. The significance was set at 0.05. Results: There were statistically significant differences between the cases and controls regarding the maternal age, number of pregnancies, p < 0.05 but none in the gestational age at delivery and birth weight, p > 0.05. There was statistically significant difference between the two groups regarding the diagnosis of placental malaria as well as past history of alcohol intake and occupation, p < 0.05. Binary logistic regression analysis showed that chronic placenta malaria infection was an independent risk factor for preeclampsia. Conclusion: Placental malaria infection was more common in patients with preeclampsia than their matched normotensive patients in our environment. At the same time, chronic malaria was found to be an independent risk factor for preeclampsia. More concerted efforts by all stake holders should be geared towards primary prevention together with early diagnosis and treatment of malaria especially in early pregnancy. This may reduce the incidence and complication of preeclampsia in our environment.