{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T02:07:12Z","timestamp":1793326032826,"version":"4.5.0"},"reference-count":22,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,8,20]],"date-time":"2022-08-20T00:00:00Z","timestamp":1660953600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,8,20]],"date-time":"2022-08-20T00:00:00Z","timestamp":1660953600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Malar J"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Malaria infection during pregnancy can cause significant morbidity and mortality to a pregnant woman, her fetus and newborn. In areas of high endemic transmission, gravidity is an important risk factor for infection, but there is a complex relationship with other exposure-related factors, and use of protective measures. This study investigated the association between gravidity and placental malaria (PM), among pregnant women aged 14\u201349 in Kintampo, a high transmission area of Ghana.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Between 2008 and 2011, as part of a study investigating the association between PM and malaria in infancy, pregnant women attending antenatal care (ANC) clinics in the study area were enrolled and followed up until delivery. The outcome of PM was assessed at delivery by placental histopathology. Multivariable logistic regression analyses were used to investigate the association between gravidity and PM, identify other key risk factors, and control for potential confounders. Pre-specified effect modifiers including area of residence, socio-economic score (SES), ITN use and IPTp-SP use were explored.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The prevalence of PM was 65.9% in primigravidae, and 26.5% in multigravidae. After adjusting for age, SES and relationship status, primigravidae were shown to have over three times the odds of PM compared to multigravidae, defined as women with 2 or more previous pregnancies [adjusted OR\u2009=\u20093.36 (95% CI 2.39\u20134.71), N\u2009=\u20091808, P\u2009&lt;\u20090.001]. The association appeared stronger in rural areas [OR for PG vs. MG was 3.79 (95% CI 3.61\u20135.51) in rural areas; 2.09 (95% CI 1.17\u20133.71) in urban areas; P for interaction\u2009=\u20090.07], and among women with lower socio-economic scores [OR for PG vs. MG was 4.73 (95% CI 3.08\u20137.25) amongst women with lower SES; OR\u2009=\u20092.14 (95% CI 1.38\u20133.35) among women with higher SES; P for interaction\u2009=\u20090.008]. There was also evidence of lower risk among primigravidae with better use of the current preventive measures IPTp and LLIN.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>The burden of PM is most heavily focused on primigravidae of low SES living in rural areas of high transmission. Programmes should prioritize primigravidae and young women of child-bearing age for interventions such as LLIN distribution, educational initiatives and treatment to reduce the burden of malaria in first pregnancy.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12936-022-04252-0","type":"journal-article","created":{"date-parts":[[2022,8,20]],"date-time":"2022-08-20T05:02:58Z","timestamp":1660971778000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Assessing the relationship between gravidity and placental malaria among pregnant women in a high transmission area in Ghana"],"prefix":"10.1186","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2458-6272","authenticated-orcid":false,"given":"Ayodele","family":"Akinnawo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaali","family":"Seyram","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen Boamah","family":"Kaali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Harrison","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Dosoo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Cairns","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kwaku Poku","family":"Asante","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,8,20]]},"reference":[{"key":"4252_CR1","volume-title":"Malaria in pregnant women","author":"WHO","year":"2018","unstructured":"WHO. 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Impact of placental Plasmodium falciparum malaria on pregnancy and perinatal outcome in sub-Saharan Africa. II: Effects of placental malaria on perinatal outcome; malaria and HIV. Yale J Biol Med. 2007;80:95\u2013103.","journal-title":"Yale J Biol Med."},{"key":"4252_CR5","doi-asserted-by":"publisher","first-page":"374","DOI":"10.1186\/s12936-017-2028-0","volume":"16","author":"SA Omer","year":"2017","unstructured":"Omer SA, Idress HE, Adam I, Abdelrahim M, Noureldein AN, Abdelrazig AM, et al. Placental malaria and its effect on pregnancy outcomes in Sudanese women from Blue Nile State. Malar J. 2017;16:374.","journal-title":"Malar J"},{"key":"4252_CR6","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1186\/s12936-020-03297-3","volume":"19","author":"EE Tran","year":"2020","unstructured":"Tran EE, Cheeks ML, Kakuru A, Muhindo MK, Natureeba P, Nakalembe M, et al. The impact of gravidity, symptomatology and timing of infection on placental malaria. 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Ghana: MCSP; 2018."}],"container-title":["Malaria Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12936-022-04252-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12936-022-04252-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12936-022-04252-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,8,20]],"date-time":"2022-08-20T17:07:46Z","timestamp":1661015266000},"score":1,"resource":{"primary":{"URL":"https:\/\/malariajournal.biomedcentral.com\/articles\/10.1186\/s12936-022-04252-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,20]]},"references-count":22,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["4252"],"URL":"https:\/\/doi.org\/10.1186\/s12936-022-04252-0","relation":{},"ISSN":["1475-2875"],"issn-type":[{"value":"1475-2875","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,20]]},"assertion":[{"value":"10 December 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 July 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 August 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Ethical approval for the original study was obtained from the ethics committees of Kintampo Health Research Centre, Ghana Health Service, LSHTM, and Noguchi Memorial Institute for Medical Research. Written informed consent was obtained from all study participants. The current study was approved by LSHTM (Ref.: 22142).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"240"}}