Malaria and pregnancy: placental cytokine expression and its relationship to intrauterine growth retardation

J Infect Dis. 1999 Dec;180(6):1987-93. doi: 10.1086/315135.


Malaria infections during pregnancy can lead to the delivery of low-birth-weight infants. In this study, cytokine mRNA was measured in placentas from 23 malaria-infected and 21 uninfected primigravid women who had delivered in Mangochi, Malawi, a region with a high rate of transmission of falciparum malaria. Significantly increased expression of interleukin (IL)-1beta, IL-8, and tumor necrosis factor (TNF)-alpha and decreased expression of IL-6 and transforming growth factor-beta1 were found in malaria-infected compared with uninfected placentas. TNF-alpha and IL-8 were produced by maternally derived hemozoin-laden placental macrophages. Increased TNF-alpha expression was associated with increased placental hemozoin concentrations. Increased TNF-alpha or IL-8 expression in the placenta was associated with intrauterine growth retardation but not with preterm delivery. The results suggest that malaria infections induce a potentially harmful proinflammatory response in the placenta.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Cytokines / biosynthesis*
  • Female
  • Fetal Growth Retardation / etiology*
  • HIV-1 / genetics
  • HIV-1 / isolation & purification
  • Hemeproteins / analysis
  • Humans
  • Immunohistochemistry
  • Infant, Newborn
  • Malaria, Falciparum / immunology*
  • Malaria, Falciparum / parasitology
  • Obstetric Labor, Premature
  • Placenta / immunology*
  • Placenta / parasitology
  • Placenta / virology
  • Pregnancy
  • Pregnancy Complications, Parasitic / immunology*
  • Pregnancy Complications, Parasitic / parasitology
  • Pregnancy Outcome
  • RNA, Messenger / genetics
  • RNA, Messenger / metabolism
  • RNA, Viral / analysis
  • Reverse Transcriptase Polymerase Chain Reaction


  • Cytokines
  • Hemeproteins
  • RNA, Messenger
  • RNA, Viral
  • hemozoin