Case report: Birth outcome and neurodevelopment in placental malaria discordant twins

Andrea L. Conroy, Paul Bangirana, Mary K. Muhindo, Abel Kakuru, Prasanna Jagannathan, Robert O. Opoka, Edward A. Liechty, Miriam Nakalembe, Moses R. Kamya, Grant Dorsey, Chandy C. John

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Maternal infection during pregnancy can have lasting effects on neurodevelopment, but the impact of malaria in pregnancy on child neurodevelopment is unknown. We present a case of a 24-year-old gravida three woman enrolled at 14 weeks 6 days of gestation in a clinical trial evaluating malaria prevention strategies in pregnancy. She had two blood samples test positive for Plasmodium falciparum using loop-mediated isothermal amplification before 20 weeks of gestation. At 31 weeks 4 days of gestation, the woman presented with preterm premature rupture of membranes, and the twins were delivered by cesarean section. Twin A was 1,920 g and Twin B was 1,320 g. Both placentas tested negative for malaria by microscopy, but the placenta of Twin B had evidence of past malaria by histology. The twins' development was assessed using the Bayley Scales of Infant and Toddler Development Third Edition. At 1 year chronologic age, Twin B had lower scores across all domains (composite scores: cognitive, Twin A [100], Twin B [70]; motor, Twin A [88], Twin B [73]; language, Twin A [109], Twin B [86]). This effect persisted at 2 years chronologic age (composite scores: cognitive, Twin A [80], Twin B [60]; motor, Twin A [76], Twin B [67]; language, Twin A [77], Twin B [59]). Infant health was similar over the first 2 years of life. We report differences in neurodevelopmental outcomes in placental malaria-discordant dizygotic twins. Additional research is needed to evaluate the impact of placental malaria on neurodevelopmental complications. Trial registration number: ClinicalTrials.gov number, NCT02163447. Registered: June 2014, https://clinicaltrials.gov/ct2/show/NCT02163447

Original languageEnglish (US)
Pages (from-to)552-555
Number of pages4
JournalAmerican Journal of Tropical Medicine and Hygiene
Volume100
Issue number3
DOIs
StatePublished - Jan 1 2019

ASJC Scopus subject areas

  • Parasitology
  • Virology
  • Infectious Diseases

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    Conroy, A. L., Bangirana, P., Muhindo, M. K., Kakuru, A., Jagannathan, P., Opoka, R. O., Liechty, E. A., Nakalembe, M., Kamya, M. R., Dorsey, G., & John, C. C. (2019). Case report: Birth outcome and neurodevelopment in placental malaria discordant twins. American Journal of Tropical Medicine and Hygiene, 100(3), 552-555. https://doi.org/10.4269/ajtmh.18-0659