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The effects of malaria in pregnancy on neurocognitive development in children at one and six years of age in Benin: a prospective mother-child cohort

Abstract : Background - Malaria in pregnancy (MiP) contributes significantly to infant mortality rates in Sub-Saharan Africa and has consequences on survivors, such as pre-term birth and low birth weight. However, its impact on long-term neurocognitive development in children remains unknown. Methods - Our prospective cohort included pregnant women and their live-born singletons from the Malaria in Pregnancy Preventive Alternative Drugs clinical trial. MiP was assessed using microscopy and real-time quantitative polymerase chain-reactions (qPCR). Neurocognitive development in children was assessed using the Mullen Scales of Early Learning and the Kaufman Assessment Battery for Children 2 nd edition (KABC-II) at one and six years of age, respectively. Results - Of 493 pregnant women, 196 (40%) were infected with malaria at least once; 121 (31%) with placental malaria diagnosed by qPCR. Multiple linear regression beta coefficients showed that impaired gross motor scores were associated with MiP at least once [-2.55 Confidence Interval (CI) (-5.15, 0.05)], placental malaria by qPCR [-4.95 CI (-7.65, -2.24)], and high parasite density at delivery [-1.92 CI (-3.86, 0.02)] after adjustment. Malaria and high parasite density at the 2 nd ANV were associated with lower KABC-II Non-Verbal Index scores at six years [-2.57 CI (-4.86, -0.28)] and [-1.91 CI (-3.51, -0.32)], respectively. Conclusions - This prospective cohort study provides evidence that MiP, particularly late-term, could have important negative consequences on child development at one and six years of age. Mechanisms behind this association must be further investigated and diagnostic methods in low-income countries should be strengthened to provide adequate treatment.
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Submitted on : Tuesday, July 27, 2021 - 3:41:47 PM
Last modification on : Wednesday, July 28, 2021 - 3:36:26 AM

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Amanda Garrison, Michael Boivin, Nadine Fiévet, Roméo Zoumenou, Jules Alao, et al.. The effects of malaria in pregnancy on neurocognitive development in children at one and six years of age in Benin: a prospective mother-child cohort. Clinical Infectious Diseases, Oxford University Press (OUP), 2021, ⟨10.1093/cid/ciab569⟩. ⟨hal-03301613⟩

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