Placental Malaria and Hypertensive Disorders of Pregnancy: A Case-Control Study in a Teaching Hospital, Ghana

Abstract

Aim: To determine the prevalence of placental malaria among women with HDP in Ghana, and its effect on fetal and pregnancy outcomes. Study Design: Case-control study. Place and Duration of Study: Obstetrics and Gynaecology unit of Tamale Teaching Hospital, Tamale, Ghana from 1st September, 2019 to 31st January, 2020. Methods: The study involved one hundred and twenty (120) parturient women (80 cases vs 40 controls). Cases were parturient women with HDP admitted at the labour ward, whereas controls were normotensive parturient women admitted for normal delivery at the labour ward. Maternal blood was taken for peripheral malaria diagnosis. Placental Malaria (PM) was diagnosed by placenta tissue examination.  Data were analysed using GraphPad Prism version 8.0, and p<.05 was considered significant. Results: The overall prevalence rate of PM was 38% (15% in control versus 53% in cases). The proportion of the malaria (placental) positive participants were different from those without PM who delivered via spontaneous vaginal delivery (64% vs 0%, p=.01) and tested positive for malaria during the pregnancy (19% vs 42%, p=.046). Higher age, being self-employed, preterm delivery complication and non-central cord insertion significantly increased the risk of developing HDP. Conclusion: There is an increased prevalence of PM among women with HDP, with resultant increased adverse outcomes such as stillbirth. The observed influence of PMI on expectant mothers and their neonates inform the need to intensify the preventive measures against malaria in pregnancy.