ABO blood group system and placental malaria in an area of unstable malaria transmission in eastern Sudan

Ishag Adam¹ , Saud Babiker² , Ahmed A Mohmmed³ , Magdi M Salih⁴ , Martin H Prins⁵ and Zaki M Zaki¹

¹Department of Obstetrics & Gynecology, Faculty of Medicine University of Khartoum, Sudan

²Faculty Of Medical Technical Sciences, Alzaiem Alazharai University, Sudan

³Faculty of Medicine, Ribat University, Sudan

⁴Faculty of Medical Laboratory Sciences, University of Khartoum, Sudan

⁵Department of Epidemiology, Care and Public Health Research Institute, University of Maastricht, The Netherlands

author email corresponding author email

Malaria Journal 2007, 6:110doi:10.1186/1475-2875-6-110


Published:	10 August 2007

Abstract

Background

Understanding the pathogenesis of malaria in pregnancy and its consequences for both the mother and the baby is fundamental for improving malaria control in pregnant women.

Aim

The study aimed to investigate the role of ABO blood groups on pregnancy outcomes in an area of unstable malaria transmission in eastern Sudan.

Methods

A total of 293 women delivering in New Half teaching hospital, eastern Sudan during the period October 2006–March 2007 have been analyzed. ABO blood groups were determined and placental histopathology examinations for malaria were performed. Birth and placental weight were recorded and maternal haemoglobin was measured.

Results

114 (39.7%), 61 (22.1%) and 118 (38.2%) women were primiparae, secundiparae and multiparae, respectively. The ABO blood group distribution was 82(A), 59 (B), 24 (AB) and 128 (O). Placental histopathology showed acute placental malaria infections in 6 (2%), chronic infections in 6 (2%), 82 (28.0%) of the placentae showed past infection and 199 (68.0%) showed no infection. There was no association between the age (OR = 1.02, 95% CI = 0.45–2.2; P = 0.9), parity (OR = 0.6, 95% CI = 0.3–1.2; P = 0.1) and placental malaria infections. In all parity blood group O was associated with a higher risk of past (OR = 1.9, 95% CI = 1.1–3.2; P = 0.01) placental malaria infection. This was also true when primiparae were considered separately (OR = 2.6, 95% CI = 1.05–6.5, P = 0.03).

Among women with all placental infections/past placental infection, the mean haemoglobin was higher in women with the blood group O, but the mean birth weight, foeto-placental weight ratio was not different between these groups and the non-O group.

Conclusion

These results indicate that women of eastern Sudan are at risk for placental malaria infection irrespective to their age or parity. Those women with blood group O were at higher risk of past placental malaria infection.