Abstract:
Background: Malaria in pregnancy increases the risk of adverse birth outcomes such as low birth weight (LBW), maternal
and foetal anemia. In Tanzania, some areas have attained low malaria transmission. However, data on the burden of
preterm delivery, LBW, maternal and foetal anemia following substantial reduction of malaria transmission in recent years
is still scarce in these settings.
Methods: A study involving 631 pregnant women was conducted at Mwananyamala referral hospital in Dar es Salaam
from April to August, 2018. Study enrollment was done prior to delivery. Structured interview and antenatal clinic cards
were used to obtain data including the use of intermittent preventive therapy in pregnancy using sulfadoxinepyrimethamine
(IPTp-SP). Infants birth weights were recorded, maternal venous and cord blood were taken for testing of
malaria and determination of haemoglobin (Hb) levels. Chi-square test and regression analysis were done to identify risk
factors for preterm delivery, LBW, maternal and foetal anemia.
Results: The prevalence of malaria among mothers who used at least one dose of IPTp-SP was 0.6% (4/631). Fourteen
mothers (2.2%) did not use IPTp-SP and had no malaria infection. The prevalence of maternal anemia, LBW, foetal
anemia and preterm delivery was 40.6, 6.5, 5.9 and 9.2% respectively. Participants who were malaria positive had 11
times more risk of LBW compared to those who were negative (AOR, 11; 95%, CI 1.07–132.2; p = 0.04). The risk of
delivering babies with LBW was 1.12 times high among mothers who were ≤ 36 weeks of gestation (AOR, 1.12; 95% CI,
0.06–0.25; p = < 0.001). The use of ≥3 doses of IPTp-SP was associated with 83% decrease in risk of LBW compared to
those who did not use any dose of IPTp-SP (AOR, 0.17; 95% CI, 0.03–0.88; p = 0.05). Severe anaemia at delivery was
associated with seven times increased risk of preterm delivery compared to non-anemic participants (AOR, 6.5; 95% CI,
1.49–28.16; p = 0.013).
