The choice of reference chart affects the strength of the association between malaria in pregnancy and small for gestational age: an individual participant data meta-analysis comparing the Intergrowth-21 with a Tanzanian birthweight chart

George Mtove, Daniel T R Minja, Omari Abdul, Samwel Gesase, Kenneth Maleta, Titus H Divala, Noel Patson, Ulla Ashorn, Miriam K Laufer, Mwayiwawo Madanitsa, Per Ashorn, Don Mathanga, Jobiba Chinkhumba, Julie R Gutman, Feiko O Ter Kuile, Sofie Lykke Møller, Ib C Bygbjerg, Michael Alifrangis, Thor Theander, John P A LusinguChristentze Schmiegelow

    Tutkimustuotos: ArtikkeliTieteellinenvertaisarvioitu

    1 Sitaatiot (Scopus)
    12 Lataukset (Pure)

    Abstrakti

    BACKGROUND: The prevalence of small for gestational age (SGA) may vary depending on the chosen weight-for-gestational-age reference chart. An individual participant data meta-analysis was conducted to assess the implications of using a local reference (STOPPAM) instead of a universal reference (Intergrowth-21) on the association between malaria in pregnancy and SGA.

    METHODS: Individual participant data of 6,236 newborns were pooled from seven conveniently identified studies conducted in Tanzania and Malawi from 2003-2018 with data on malaria in pregnancy, birthweight, and ultrasound estimated gestational age. Mixed-effects regression models were used to compare the association between malaria in pregnancy and SGA when using the STOPPAM and the Intergrowth-21 references, respectively.

    RESULTS: The 10th percentile for birthweights-for-gestational age was lower for STOPPAM than for Intergrowth-21, leading to a prevalence of SGASTOPPAM of 14.2% and SGAIG21 of 18.0%, p < 0.001. The association between malaria in pregnancy and SGA was stronger for STOPPAM (adjusted odds ratio (aOR) 1.30 [1.09-1.56], p < 0.01) than for Intergrowth-21 (aOR 1.19 [1.00-1.40], p = 0.04), particularly among paucigravidae (SGASTOPPAM aOR 1.36 [1.09-1.71], p < 0.01 vs SGAIG21 aOR 1.21 [0.97-1.50], p = 0.08).

    CONCLUSIONS: The prevalence of SGA may be overestimated and the impact of malaria in pregnancy underestimated when using Intergrowth-21. Comparing local reference charts to global references when assessing and interpreting the impact of malaria in pregnancy may be appropriate.

    AlkuperäiskieliEnglanti
    Artikkeli292
    JulkaisuMalaria Journal
    Vuosikerta21
    Numero1
    DOI - pysyväislinkit
    TilaJulkaistu - 12 lokak. 2022
    OKM-julkaisutyyppiA1 Alkuperäisartikkeli tieteellisessä aikakauslehdessä

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