{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T18:13:16Z","timestamp":1759342396302,"version":"build-2065373602"},"reference-count":21,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,1]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>Preeclampsia (PreE) and placental malaria (PM) are leading causes of perinatal morbidity and mortality in Africa with overlapping pathophysiology. Utilizing data collected during a randomized, controlled clinical trial of intermittent preventive therapy during pregnancy in Malawi, we examined the association between PM and PreE, including severe manifestations, such as eclampsia. All singleton pregnancies with placental histopathology and polymerase chain reaction (PCR) were included. Among 751 pregnancies, 125 (16.7%) had evidence of PM by histopathology or PCR identifying PM parasites, including 105 with hemozoin pigment indicative of infection during early pregnancy. Twenty-five patients (3.3%) had PreE without eclampsia, 6 (0.7%) had eclampsia, and 98 (13.0%) had any hypertensive disorder. Individuals with hemozoin had nearly twice the rate of PreE as those without, although this difference did not achieve statistical significance (6.7% versus 3.7%, <jats:italic>P<\/jats:italic> = 0.16). This study is limited by sample size and was underpowered to detect this difference. Further research characterizing the relationship between PM and PreE is warranted.<\/jats:p>","DOI":"10.4269\/ajtmh.25-0187","type":"journal-article","created":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T19:59:24Z","timestamp":1752782364000},"page":"817-820","source":"Crossref","is-referenced-by-count":0,"title":["The Relationship between Placental Malaria and Preeclampsia in Blantyre, Malawi"],"prefix":"10.4269","volume":"113","author":[{"given":"Sarah","family":"Boudova","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Thomas Jefferson University Sidney Kimmel Medical College, Philadelphia, Pennsylvania;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Titus H.","family":"Divala","sequence":"additional","affiliation":[{"name":"Kamuzu University of Health Sciences, Blantyre, Malawi;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Randy","family":"Mungwira","sequence":"additional","affiliation":[{"name":"World Health Organization, Malawi Office, Lilongwe, Malawi;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patricia","family":"Mawindo","sequence":"additional","affiliation":[{"name":"Blantyre Malaria Project, Blantyre, Malawi;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tamiwe","family":"Tomoka","sequence":"additional","affiliation":[{"name":"Pathology Department, University of Malawi College of Medicine, Blantyre, Malawi;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miriam K.","family":"Laufer","sequence":"additional","affiliation":[{"name":"Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Lancet Glob Health","first-page":"e40","article-title":"Global estimates of the number of pregnancies at risk of malaria from 2007 to 2020: A demographic study","volume":"11","author":"Reddy","year":"2023"},{"key":"b2","series-title":"Lancet Infect Dis","first-page":"93","article-title":"Epidemiology and burden of malaria in pregnancy","volume":"7","author":"Desai","year":"2007"},{"key":"b3","series-title":"Lancet Glob Health","first-page":"e323","article-title":"Global causes of maternal death: A WHO systematic analysis","volume":"2","author":"Say","year":"2014"},{"key":"b4","series-title":"Eur J Obstet Gynecol Reprod Biol","first-page":"1","article-title":"Global and regional estimates of preeclampsia and eclampsia: A systematic review","volume":"170","author":"Abalos","year":"2013"},{"key":"b5","series-title":"J Reprod Immunol","first-page":"1","article-title":"Placental malaria and pre-eclampsia through the looking glass backwards?","volume":"65","author":"Brabin","year":"2005"},{"key":"b6","series-title":"Malar J","first-page":"11","article-title":"Usefulness of a biomarker to identify placental dysfunction in the context of malaria","volume":"16","author":"Gueneuc","year":"2017"},{"key":"b7","series-title":"J Infect Dis","first-page":"1425","article-title":"Malaria in early pregnancy and the development of the placental vasculature","volume":"220","author":"Moeller","year":"2019"},{"key":"b8","series-title":"Am J Trop Med Hyg","first-page":"503","article-title":"Seasonal variation in direct obstetric mortality in rural Senegal: Role of malaria?","volume":"68","author":"Etard","year":"2003"},{"key":"b9","series-title":"Am J Trop Med Hyg","first-page":"510","article-title":"Seasonal variation in the risk and causes of maternal death in The Gambia: Malaria appears to be an important factor","volume":"70","author":"Anya","year":"2004"},{"key":"b10","series-title":"Malar J","first-page":"258","article-title":"Malaria and pre-eclampsia in an area with unstable malaria transmission in central Sudan","volume":"10","author":"Adam","year":"2011"},{"key":"b11","series-title":"Am J Epidemiol","first-page":"847","article-title":"Placental malarial infection as a risk factor for hypertensive disorders during pregnancy in Africa: A case-control study in an urban area of Senegal, West Africa","volume":"170","author":"Ndao","year":"2009"},{"key":"b12","series-title":"Lancet","first-page":"1121","article-title":"Malaria associated pre-eclampsia in Senegal","volume":"347","author":"Sartelet","year":"1996"},{"key":"b13","series-title":"BMC Med","first-page":"98","article-title":"Falciparum but not vivax malaria increases the risk of hypertensive disorders of pregnancy in women followed prospectively from the first trimester","volume":"19","author":"Harrington","year":"2021"},{"key":"b14","series-title":"East Afr Health Res J","first-page":"141","article-title":"Placental parasitic infections and pregnancy outcomes among women delivering at a tertiary hospital in northern Tanzania","volume":"6","author":"Felician","year":"2022"},{"key":"b15","series-title":"PLoS Med","first-page":"e446","article-title":"Hypertension and maternal-fetal conflict during placental malaria","volume":"3","author":"Muehlenbachs","year":"2006"},{"key":"b16","series-title":"Sci Rep","first-page":"8280","article-title":"Histopathological lesions and exposure to Plasmodium falciparum infections in the placenta increases the risk of preeclampsia among pregnant women","volume":"10","author":"Obiri","year":"2020"},{"key":"b17","series-title":"Trop Med Int Health","first-page":"770","article-title":"Malaria in pregnancy: Adverse effects on haemoglobin levels and birthweight in primigravidae and multigravidae","volume":"6","author":"Shulman","year":"2001"},{"key":"b18","series-title":"Lancet Infect Dis","first-page":"1097","article-title":"Chloroquine as weekly chemoprophylaxis or intermittent treatment to prevent malaria in pregnancy in Malawi: A randomised controlled trial","volume":"18","author":"Divala","year":"2018"},{"key":"b19","series-title":"J Infect Dis","first-page":"732","article-title":"Placental but not peripheral Plasmodium falciparum infection during pregnancy is associated with increased risk of malaria in infancy","volume":"216","author":"Boudov\u00e1","year":"2017"},{"key":"b20","series-title":"Obstet Gynecol","first-page":"e237","article-title":"Gestational hypertension and preeclampsia: ACOG Practice Bulletin, Number 222","volume":"135","year":"2020"},{"key":"b21","series-title":"Malar J","first-page":"422","article-title":"The prevalence of malaria at first antenatal visit in Blantyre, Malawi declined following a universal bed net campaign","volume":"14","author":"Boudov\u00e1","year":"2015"}],"container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/113\/4\/article-p817.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/113\/4\/article-p817.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/113\/4\/article-p817.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T17:29:50Z","timestamp":1759339790000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/113\/4\/article-p817.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,1]]},"references-count":21,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.25-0187","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"type":"print","value":"0002-9637"},{"type":"electronic","value":"1476-1645"}],"subject":[],"published":{"date-parts":[[2025,10,1]]}}}