Morphology of the Placenta in Women Infected with Malaria During Pregnancy

Abstract

Malaria in pregnancy may cause changes in maternal-fetal perfusion contributing to adverse pregnancy outcomes. It is not fully understood how malaria in pregnancy alters the terminal villus and how these relate to pregnancy outcomes. We investigated placenta terminal villi morphology in patients with and without malaria in pregnancy. The study followed a retrospective cohort design in which 116 placentae, 58 from mothers who have had malaria in pregnancy and 58 from mothers without a history of malaria in pregnancy were assessed by histological examination. Statistical analyses were performed using SPSS (version 21) to compare features of the placenta in the two groups. Ethical approval was obtained and guidelines were strictly adhered to. From the findings, the odds of having low placental weight were significantly higher for those with malaria compared to those without malaria (mean placental weights 478.27g ± 40.95 and 511.55g ± 35.58 respectively; P=0.001, OR=4.424). Morphometric analyses showed significantly higher counts of syncytialknot (p-value <0.001, CI: 1.549 - 4.596) and delamination (p-value 0.01, CI: 0.715 -4.667), fibrin deposition (p-value 0.009, CI: 0.029 - 0.188), smaller intervillous space area (p-value 0.036, CI: -0.013- -0.362) and (p-value 0.004, CI: 0.846 - 3.98) in placenta from mothers with malaria in pregnancy compared to the non-exposed group. The findings offer a morphological basis for comprehending adverse pregnancy outcomes in women affected by malaria during pregnancy. It is imperative to implement aggressive treatment measures to mitigate the severity of adverse feto-maternal outcomes resulting from malaria infection in pregnant women.