Maternal Malaria, Birth Size and Blood Pressure in Nigerian Newborns Insights into the Developmental Origins of Hypertension from the Ibadan Growth Cohort 英文参考文献.docVIP

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Maternal Malaria, Birth Size and Blood Pressure in Nigerian Newborns Insights into the Developmental Origins of Hypertension from the Ibadan Growth Cohort 英文参考文献.doc

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Maternal Malaria, Birth Size and Blood Pressure in Nigerian Newborns Insights into the Developmental Origins of Hypertension from the Ibadan Growth Cohort 英文参考文献

MaternalMalaria,BirthSizeandBloodPressurein NigerianNewborns:InsightsintotheDevelopmental OriginsofHypertensionfromtheIbadanGrowthCohort OmololaO.Ayoola1,2*,IslaGemmell1,OlayemiO.Omotade2,OlusojiA.Adeyanju3,J.Kennedy Cruickshank1.,PeterEllisClayton1. 1Endocrine and Cardiovascular Sciences Group, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, United Kingdom, 2College of Medicine,UniversityofIbadan,Ibadan,Nigeria,3DepartmentofObstetricsandGynecology,AdeoyoMaternityHospital,Ibadan,Nigeria Abstract Background:Hypertensionisanincreasinghealthissueinsub-SaharanAfricawheremalariaremainscommoninpregnancy. WeestablishedabirthcohortinNigeriatoevaluatetheearlyimpactofmaternalmalariaonnewbornbloodpressure(BP). Methods: Anthropometric measurements, BP, blood films for malaria parasites and haematocrit were obtained in 436 mother-babypairs.Womenweregroupedtodistinguishbetweenthetimingofmalariaparasitaemiaas‘NoMalaria’,‘Malaria duringpregnancyonly’or‘Malariaatdelivery’,andparasitedensityaslow(,1000parasites/mlofblood)andhigh($1000/ ml). Results: Prevalence of maternal malaria parasitaemia was 48%, associated with younger maternal age (p,0.001), being primigravid (p=0.022), lowerhaematocrit (p=0.028). Highparasite density through pregnancy hadthelargesteffect on meanbirthindicessothatweight,length,headandmid-upperarmcircumferencesweresmallerby300g,1.1cm,0.7cm and0.4cmrespectivelycomparedwith‘Nomalaria’(allp#0.005).Inbabiesofmotherswhohad‘malariaatdelivery’,their SBPs adjusted for other confounders were lower respectively by 4.3 and 5.7mmHg/kg compared with ‘malaria during pregnancyonly’or‘none’.Incontrastthemeannewbornsystolic(SBP)anddiastolicBPs(DBP)adjustedforbirthweight werehigherby1.7and1.4mmHg/kgrespectivelyinbabieswhosemothershadhighcomparedwithlowparasitaemia. Conclusions:Asexpected,prenatalmalarialexposurehadasignificantimpactonfetalgrowthrates.Malariaatdeliverywas associated withthelowest newborn BPswhile malariathrough pregnancy, which