Age-related factors associated with placental malaria and adverse pregnancy outcomes in rural Burkina Faso

Malaria control and elimination remained challenging in sub-Saharan Africa where pregnant women and their fetuses are mostly affected. The current strategy proposed by the WHO and its partners for accelerating progress toward malaria elimination is to use quality data for targeting and tailoring interventions toward those needing them most. The overall objective of our study was to contribute to improving the control of malaria in pregnancy through adequate identification of high-risk groups that could be potentially targeted by programs for specific actions or strategies. Specifically, we aimed at 1) determining the prevalence of placental malaria and assessing whether its associated factors are varying with age; 2) determining the low birth weight or prematurity prevalence in newborns from mothers infected with malaria and its burden in teenagers; 3) accurately estimating fetal biometry in pregnant women with malaria in rural settings for gestational age and abnormal fetal size determination. We analyzed data from pregnant women treated for malaria in the framework of a clinical trial and explored interactions between age and maternal factors. We found that young pregnant women with low gravidity, anemia, and presenting with symptoms like fever were more at risk of placental malaria and delivered more low birth weight or preterm neonates than their older counterparts. Also, the estimation of the fetal size in these women varied with the reference biometric chart used. Our findings are in line with the approach in the fight against malaria. They point out the need for comprehensive interventions targeting young pregnant women including malaria prevention and treatment but also nutritional support. Ultrasound practice should be standardized, particularly the choice of ultrasound reference biometric chart for accurate gestational age and fetal size estimation. This might benefits greatly the fetuses of the young mothers affected by malaria in pregnancy