Adverse Obstetric Outcomes among Women with Placental Malaria from Peri-Urban Ghana

Abstract

Placental malaria (PM) poses a major threat to both the mother and the unborn child. Maternal anemia and intrauterine growth retardation are major consequences of PM. The risk of dying from malaria is also higher among pregnant women than the general population as high levels of parasitaemia, hypoglycemia, acute pulmonary edema, foetal distress, premature labour, spontaneous abortions and still births are common among pregnant women with malaria. This case control study examined maternal outcomes in 420 pregnant women (220 with PM as case and 200 without PM as control) attending antenatal clinics at Pramso, a high malaria transmission area in Ghana. PM was high (12.3%) in the study area despite the implementation of the recommended World Health Organization (WHO) guidelines for interventions. Maternal anemia was significantly higher (p<0.001) in pregnant women with PM than those without PM. Parity (p<0.001), Premature rupture of membranes (PROM) (p< 0.001), foul smelling liquor (FSL) p< 0.05) and Meconium stained amniotic fluid (MSAF (p<0.001) were found to be associated with placental malaria. Primiparous pregnant women were more likely to have PM than multiparous pregnant women. The frequencies of PROM, FSL, MSAF were significantly higher in pregnant women with PM than those without. Ante and Post partum Haemorrhage (APH/PPH) and Pregnancy-induced hypertension (PIH) on the other hand had no statistically significant association with PM. Antenatal care should intensify the implementation of the WHO guidelines as well as prevention and prompt management of the adverse obstetric outcomes associated with PM.