Endocrine Abstracts

Introduction: As in most sub-Saharan Africa, hypertension and its complications are increasingly common in Nigeria, where malaria is hyper-endemic. We established a birth cohort in Ibadan to assess the impact of maternal malaria on blood pressure (BP) in Nigerian infants over their first year.

Methods: Healthy pregnant women with singleton pregnancies were followed to delivery. They had regular blood films for malaria parasites through to delivery. Growth and BP were measured on 318 babies, all followed from birth to 3 and 12 months. Analysis used multiple regression techniques for longitudinal data.

Results: Babies exposed to maternal malaria were shorter, smaller and thinner at birth and remained smaller at 1 year, most marked in boys, whose systolic (S)BP adjusted for weight at 3 and 12 months was higher than those not exposed (at 3 months +0.6 mmHg/kg, 95% CI 0–1.2, P=0.04). Change in SBP over the first year was greater in boys than girls (20.9 vs 15.7 mmHg P=0.002) but greater in girls exposed to maternal malaria (18.7 vs 12.7 mmHg, 95% CI 1–11, P=0.02). 11% of boys (> twice expected) had a SBP >95th percentile (hypertensive, US criteria) of whom 68% had maternal malaria exposure. On regression analysis, gender, maternal malaria exposure and weight change all independently increased change in BP to 1 year.

Conclusions: Maternal malaria exposure had a greater adverse effect on growth in boys than girls. Malaria exposed boys had a higher than expected incidence of hypertension at one year, but the girls had a greater increase in BP. Thus intrauterine exposure to malaria has important gender-dependent effects on growth and infant BP and may contribute to the global burden of hypertension.