The prevalence of infants born with low cord haemoglobin (fetal anaemia) is high in areas where malaria and iron deficiency anaemia in pregnancy are common. The objective of the present study was to determine risk factors for fetal anaemia in an area of high malaria transmission in southern Malawi. A case control study was undertaken with fetal anaemia defined as cord haemoglobin (Hb) < 12.5 g/dl. Between March 1993 and July 1994, pregnant women attending the study hospitals for the first time in that pregnancy were enrolled. Data on socio-economic status, anthropometry, previous obstetric history and current pregnancy were collected. Malaria parasitaemia, Hb levels and iron status were measured in maternal blood at recruitment and delivery and in umbilical venous blood. Fetal anaemia occurred in 23.4% of babies. Mean (SD) cord Hb was 13.6 g/dl (1.83). Factors associated with fetal anaemia were: birth in the rainy season [adjusted odds ratio (AOR) 2.33, 95% CI 1.73-3.14], pre-term delivery (AOR 1.60, 1.03-2.49), infant Hb < 14 g/dl at 24 hours (AOR 2.35, 1.20-4.59), maternal Hb at delivery < 8 g/dl (AOR 1.61, 1.10-2.42) or <11 g/dl (AOR 1.60, 1.10-2.31). A higher prevalence of fetal anaemia occurred with increasing peripheral Plasmodium falciparum parasite density (p=0.03) and geometric mean placental parasite densities were higher in babies with fetal anaemia than in those without (3331 vs 2152 parasites/microl, p=0.07). Interventions should aim to reduce fetal anaemia by improving malaria and anaemia control in pregnancy and by addressing the determinants of pre-term delivery.
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机译：在脐带血红蛋白低下（胎儿贫血）出生的婴儿在妊娠疟疾和铁缺乏性贫血很普遍的地区患病率很高。本研究的目的是确定马拉维南部疟疾高传播地区胎儿贫血的危险因素。胎儿贫血的定义为脐带血红蛋白（Hb）<12.5 g / dl。在1993年3月至1994年7月之间，首次登记了参加该研究医院的孕妇。收集有关社会经济状况，人体测量学，以前的产科史和当前怀孕的数据。在募集和分娩时的母体血液和脐带静脉血中测量疟疾寄生虫血症，血红蛋白水平和铁状态。胎儿贫血发生在23.4％的婴儿中。平均（SD）帘线Hb为13.6 g / dl（1.83）。与胎儿贫血相关的因素有：雨季出生[校正比值比（AOR）2.33，95％CI 1.73-3.14]，早产（AOR 1.60，1.03-2.49），婴儿Hb <14 g / dl 24小时（AOR 2.35，1.20-4.59），分娩时孕妇Hb <8 g / dl（AOR 1.61，1.10-2.42）或<11 g / dl（AOR 1.60，1.10-2.31）。胎儿贫血的患病率较高，其周围恶性疟原虫的寄生虫密度增加（p = 0.03），几何学平均胎盘寄生虫密度高于无贫血的婴儿（3331 vs 2152寄生虫/微升，p = 0.07）。干预措施应旨在通过改善孕妇的疟疾和贫血控制以及解决早产的决定因素来减少胎儿贫血。
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