Pregnancy outcomes in women with imported malaria in mainland France: A retrospective study from 2004 to 2014

P Imbert; J Nizard; G Werkoff; E Kendjo; C Ficko; M Thellier; “PALUFEN Group”

doi:10.1016/j.tmaid.2024.102727

Pregnancy outcomes in women with imported malaria in mainland France: A retrospective study from 2004 to 2014

Travel Med Infect Dis. 2024 May 19:60:102727. doi: 10.1016/j.tmaid.2024.102727. Online ahead of print.

Authors

P Imbert¹, J Nizard², G Werkoff³, E Kendjo⁴, C Ficko¹, M Thellier⁵; “PALUFEN Group”

Affiliations

¹ Service des maladies infectieuses et tropicales, Hôpital d'instruction des armées Bégin, 69 Avenue de Paris, 94160, Saint-Mandé, France.
² Service de gynécologie obstétrique, Hôpital Pitié-Salpêtrière, Assistance Publique des Hôpitaux de Paris, 47 Boulevard de L'Hôpital, 75013, Paris, France.
³ Service de gynécologie, Hôpital d'instruction des armées Bégin, 69 Avenue de Paris, 94160, Saint-Mandé, France.
⁴ Service de parasitologie-mycologie, Centre National de Référence du paludisme, Hôpital Pitié-Salpêtrière, Assistance Publique des Hôpitaux de Paris, 47 Boulevard de L'Hôpital, 75013, Paris, France.
⁵ Service de parasitologie-mycologie, Centre National de Référence du paludisme, Hôpital Pitié-Salpêtrière, Assistance Publique des Hôpitaux de Paris, 47 Boulevard de L'Hôpital, 75013, Paris, France; UMRS 1136, Institut Pierre-Louis d'épidémiologie et de santé publique (IPLESP), Sorbonne Université, 27 Rue Chaligny, 75571, Paris 12, France; UPMC, Faculté de médecine, Sorbonne Université, Université Pierre-et-Marie-Curie, 91 Boulevard de l'Hôpital, 75013, Paris, France.

PMID: 38768905
DOI: 10.1016/j.tmaid.2024.102727

Abstract

Objectives: There is little data on pregnant women with imported malaria in high-income countries, especially regarding offspring outcomes. We wanted to determine pregnancy outcomes of imported malaria in pregnant women in mainland France.

Patients and methods: We conducted a retrospective, descriptive study of outcomes in pregnant women hospitalized with malaria from 2004 to 2014 in two regions of mainland France. An adverse outcome was defined as a miscarriage, stillbirth, preterm birth (<35 weeks of gestation), low birth weight (LBW) defined as less than 2500 g, or congenital malaria.

Results: Of 60 pregnancies, 5 were excluded because of elective abortions; 55 were investigated, of which 11 were primigravidae and 44 multigravidae. Pregnancies were singleton (n = 51) or twin (n = 4). Mean age was 30.4 years (range:19-45 y). Among the 55 cases, 9 ended in a miscarriage (8 singletons and 1 twin pregnancy) and 1 had a stillbirth at 21 weeks of gestation, all immediately after the malarial episode. 45 gave birth (29 vaginal deliveries and 16 caesarean sections) to 48 (42 singletons and 6 twins) newborns. Amongst these, 30 were healthy full-term newborns, 10 had LBW, and 8 were preterm. Overall, 26 of 55 (47.3%) pregnancies, and 29 of 59 (49.2%) offsprings had adverse outcomes. Compared to singleton pregnancies, twin pregnancies were associated with adverse outcomes (p = 0.0438).

Conclusions: Imported malaria has a severe impact on pregnancy outcomes. Prevention and management of imported malaria in pregnancy should be optimized.

Keywords: France; Imported malaria; Outcome; Pregnancy; Screening.