Unger, Holger W

Hadiprodjo, Anastasia Jessica

Gutman, Julie R

Briand, Valerie

Fievet, Nadine

Valea, Innocent

Tinto, Halidou

D'Alessandro, Umberto

Landis, Sarah H

Ter Kuile, Feiko

Ouma, Peter

Oneko, Martina

Mwapasa, Victor

Slutsker, Laurence

Terlouw, Dianne J

Kariuki, Simon

Ayisi, John

Nahlen, Bernard

Desai, Meghna

Madanitsa, Mwayi

Kalilani-Phiri, Linda

Ashorn, Per

Maleta, Kenneth

Tshefu-Kitoto, Antoinette

Mueller, Ivo

Stanisic, Danielle

Cates, Jordan

Van Eijk, Anna Maria

Ome-Kaius, Maria

Aitken, Elizabeth H

Rogerson, Stephen J

2023

In areas of moderate to intense Plasmodium falciparum transmission, malaria in pregnancy remains a significant cause of low birth weight, stillbirth, and severe anaemia. Previously, fetal sex has been identified to modify the risks of maternal asthma, pre-eclampsia, and gestational diabetes. One study demonstrated increased risk of placental malaria in women carrying a female fetus. We investigated the association between fetal sex and malaria in pregnancy in 11 pregnancy studies conducted in sub-Saharan African countries and Papua New Guinea through meta-analysis using log binomial regression fitted to a random-effects model. Malaria infection during pregnancy and delivery was assessed using light microscopy, polymerase chain reaction, and histology. Five studies were observational studies and six were randomised controlled trials. Studies varied in terms of gravidity, gestational age at antenatal enrolment and bed net use. Presence of a female fetus was associated with malaria infection at enrolment by light microscopy (risk ratio 1.14 [95% confidence interval 1.04, 1.24]; P = 0.003; n = 11,729). Fetal sex did not associate with malaria infection when other time points or diagnostic methods were used. There is limited evidence that fetal sex influences the risk of malaria infection in pregnancy.

Department of Obstetrics and Gynaecology, Royal Darwin Hospital, Darwin, NT, Australia.

Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia.

Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK.

Department of Medicine (RMH), Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, VIC, Australia.

Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA.

Université de Paris, UMR261, IRD, Paris, France.

Epicentre MSF, Paris, France.

Unite de Recherche Clinique de Nanoro, Institut de Recherche en Sciences de La Santé-DRCO, Nanoro, Burkina Faso.

Departement de Recherche Clinique, Centre Muraz, Bobo-Dioulasso, Burkina Faso.

Medical Research Council Unit, The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, Gambia.

London School of Hygiene and Tropical Medicine, London, UK.

BioMarin Pharmaceutical, London, UK.

Kenya Medical Research Institute (KEMRI)/Centre for Global Health Research, Kisumu, Kenya.

School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi.

Malaria and Neglected Tropical Diseases, Center for Malaria Control and Elimination, PATH, Seattle, WA, USA.

Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi.

President's Malaria Initiative, Washington, DC, USA.

Malawi University of Science and Technology, Thyolo, Malawi.

Faculty of Medicine and Health Technology, Center for Child, Adolescent and Maternal Health Research, Tampere University, Tampere, Finland.

Department for Pediatrics, Tampere University Hospital, Tampere, Finland.

School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of Congo.

Walter and Eliza Hall Institute, Parkville, VIC, Australia.

Institute for Glycomics, Griffith University, Gold Coast, QLD, Australia.

Department of Epidemiology, UNC-Chapel Hill, Chapel Hill, NC, USA.

Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea.

Department of Infectious Diseases, Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, VIC, Australia.

Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, VIC, Australia.

Department of Medicine (RMH), Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, VIC, Australia. sroger@unimelb.edu.au.

Department of Infectious Diseases, Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, VIC, Australia. sroger@unimelb.edu.au.

Department of Microbiology and Immunology, Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, VIC, Australia. sroger@unimelb.edu.au.

© 2023. The Author(s).

Sci Rep. 2023 Jun 26;13(1):10310. doi: 10.1038/s41598-023-37431-3.

https://pubmed.ncbi.nlm.nih.gov/37365258/?otool=iaurydwlib

https://hdl.handle.net/10137/12488

13

Infant, Newborn

Female

Pregnancy

Humans

Plasmodium falciparum

Placenta

*Malaria/epidemiology/complications

Infant, Low Birth Weight

Stillbirth

*Malaria, Falciparum/epidemiology/complications

Fetal sex and risk of pregnancy-associated malaria in Plasmodium falciparum-endemic regions: a meta-analysis.

Journal Article

Meta-Analysis

Research Support, N.I.H., Extramural

Research Support, Non-U.S. Gov't

Publication