Prevalence and Factors Associated with Histological Placental Abnormalities among Malaria Smear Positive Women Delivering at Two Tertiary Hospitals, Uganda
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Date
2023-03
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Kampala International University; Faculty of Cinical Medicine and Dentistry
Abstract
Background: Malaria in pregnancy, a major public health concern, remains one of the commonest and easily preventable cause of poor pregnancy outcomes worldwide, and placental abnormality is believed to be the main mechanism by which malaria in pregnancy causes adverse obstetric outcomes. Knowledge of the prevalence and factors associated with histological placental abnormality is a mainstay strategy, which can help to reduce the burden of poor obstetric outcomes among malaria smear positive women.
Methods: This was a multicenter hospital-based cross-sectional study conducted at the maternity wards of JRRH and HRRH between September and November 2022. A sample of 124 malaria smear positive women were recruited, open-ended questionnaires were administered, and after delivery, Gross and histological assessment of the placenta was done. Slides were analyzed and results of histologic findings were documented. The factors associated with histological placental abnormality were assessed using logistic regression.
Results: The prevalence of histological placental abnormality among malaria smear positive women admitted for delivery at JRRH and HRRH was 61.3%. The commonest histological placental abnormalities finding was infarction (29.8%) followed by inflammation (26.6%). Level of parasitemia (aOR: 5.03, 95%C.I:2.19-6.56, p=0.01), primigravidae (aOR: 2.82, 95% C.I: 1.19-3.57 p=0.04) and history of malaria in the pregnancy (aOR: 11.26(1.08-17.37; p=0.04) were associated with histological placental abnormalities among malaria smear positive women delivering at JRRH and HRRH.
Conclusions: The prevalence of histological placental abnormalities was high compared to the national levels. The most common histological placental abnormalities were infarction and inflammation. Primigravidae, history of malaria in the pregnancy and level of parasitemia >1000ul are the independent predictors of placental histological abnormalities among blood smear positive women delivering at JRRH and HRRH.