Hypertension and maternal–fetal conflict during placental malaria

Mutabingwa, Theonest K.

Hypertension and maternal–fetal conflict during placental malaria

dc.contributor.author	Mutabingwa, Theonest K.
dc.date.accessioned	2020-03-09T11:28:20Z
dc.date.available	2020-03-09T11:28:20Z
dc.date.issued	2006
dc.description.abstract	Background: Malaria and hypertension are major causes of maternal mortality in tropical countries,especially during first pregnancies, but evidence for a relationship between these syndromes iscontradictory. Methods and Findings: In a cross-sectional survey of Tanzanian parturients, the rate of hypertension was similar inplacental malaria (PM)-positive (11/85 = 13%) and PM-negative (73/602 = 12%) individuals.However, we found that PM was associated with hypertension in first-time mothers aged 18–20 ybut not other mothers. Hypertension was also associated with histologic features of chronicmalaria, which is common in first-time mothers. Levels of soluble vascular endothelial growthfactor receptor 1 (sVEGFR1), a preeclampsia biomarker, were elevated in first-time mothers witheither PM, hypertension, or both, but levels were not elevated in other mothers with theseconditions. In first-time mothers with PM, the inflammatory mediator vascular endothelial growthfactor (VEGF) was localized to maternal macrophages in the placenta, while sVEGFR1, its solubleinhibitor, was localized to the fetal trophoblast. Conclusions: The data suggest that maternal–fetal conflict involving the VEGF pathway occurs during PM,and that sVEGFR1 may be involved in the relationship between chronic PM and hypertension infirst-time mothers. Because placental inflammation causes poor fetal outcomes, wehypothesize that fetal mechanisms that promote sVEGFR1 expression may be under selectivepressure during first pregnancies in malaria-endemic areas.	en_US
dc.identifier.citation	Muehlenbachs, A., Mutabingwa, T.K., Edmonds, S., Fried, M. and Duffy, P.E., 2006. Hypertension and maternal–fetal conflict during placental malaria. PLoS medicine, 3(11).	en_US
dc.identifier.other	doi:10.1371/ journal.pmed.0030446
dc.identifier.uri	http://hdl.handle.net/123456789/314
dc.language.iso	en	en_US
dc.publisher	PLoS medicine	en_US
dc.subject	Hypertension	en_US
dc.subject	Placental malaria	en_US
dc.subject	Maternal–fetal	en_US
dc.title	Hypertension and maternal–fetal conflict during placental malaria	en_US
dc.type	Article	en_US