Meta-Analysis: The Effect of Malaria Infection on the Incidence of Low Birth Weight

Feri Yuda Anggara, Setyo Sri Rahardjo, Bhisma Murti


Background: Malaria is a parasitic infectious disease. Malaria contributes to morbidity and mortality in high-risk groups, namely pregnant women and children under five. Malaria infec­tion during pregnancy can adversely affect both the mother and the fetus, including maternal anemia, miscarriage, preterm labor, intra­uterine growth retardation, and the delivery of infants with low birth weight (LBW). This study aims to analyze the magnitude of the influence of malaria infection on the incidence of LBW by a meta-analysis study.

Subjects and Method: This was a systematic review and meta-analysis conducted by follow­ing the PRISMA flow diagram. The process of searching for articles is carried out through a journal database which includes: PubMed, Springer Link, Google Scholar and Science Direct by selecting articles published in 2000-2020. Keywords used include: “Malaria infec­tion AND low birth weight", "malaria during pregnant "AND" low birth weight", "malaria during pregnant AND low birth weight AND adjusted ratio". The inclusion criteria were full paper articles with observational study design, articles using English, multivariate analysis used with adjusted odds ratio. Articles that meet the requirements are analyzed using the Revmen5.3 application.

Results: Thirteen articles were reviewed in this study with a cohort and cross-sectional study design. Meta-analysis of 4 cohort studies showed that pregnant women with malaria infection had a 1.31 times increased risk of low birth weight compared with those without malaria infection (aOR= 1.31; 95% CI= 0.90 to 1.90; p= 0.15). A meta-analysis of 9 cross-sectional studies showed that pregnant women with malaria infection had a 2.11 times increased risk of low birth weight compared with those without malaria infection (aOR= 2.11; 95% CI= 1.33 to 3.33; p= 0.001).

Conclusion: Malaria infection increases the risk of low birth weight.

Keywords: malaria infection, low birth weight

Correspondence: Feri Yuda Anggara. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: Mobile: 085­220426805.

Journal of Maternal and Child Health (2020), 05(05): 549-562


Full Text:



Adegnika AA, Verweij JJ, Agnandji ST, Chai SK, Breitling LP, Ramharter M, Frolich M, Issifou S, Kremsner PG, Yazdanbakhsh M (2006). Microscopic and sub-microscopic Plasmodium falciparum infection, but not inflam-mation caused by infection, is asso-ciated with low birth weight. AmJ Trop Med Hyg. 75(5): 798–803.

Albiti AH, Adam I, Ghouth AS (2010). Pla-cental malaria, anaemia and low birthweight in Yemen. Trans R Soc Trop Med Hyg. 104(1):191–194. https-://

Alvarez MV, Abellana R, Cot M (2014). Pregnancy-associated malaria and malaria in infants: an old problem with present consequences. Malar J. 13(1): 1–10.

Asundep N N, Jolly PE, Carson AP, Turpin CA, Zhang K, Wilson NO, Stiles JK (2014). Effect of malaria and geohel-minth infection on birth outcomes in Kumasi, Ghana.Int J Trop Dis Health. 4(5):582–594. doi: 10.9734/IJTDH/ 2014/7573.

Briand V, Saal J, Ghafari C, Huynh B, Fievet N, Schmiegelow C, Massougbo-dji A (2016). Fetal growth restriction is associated with malaria in preg-nancy: a prospective longitudinal study in Benin. J Infect Dis. 214(3): 417–425.

Brutus L, Santalla J, Schneider D, Avila JC, Deloron P (2013). Plasmodium vivax malaria during pregnancy in Bolivia. Emerging Infect. Dis. 19(10):1605–1611.

Buck E, Finnigan NA (2019). Malaria. Stat Pearls Publishing LLC. NCBI Book-shelf ID: NBK551711PMID: 31869175.

CDC (2020). Malaria. Diakses tanggal 25 Oktober 2020

CEBMa (2014). Critical Appraisal. Amster-dam: Center for Evidence Based Management

Cottrell G, Moussiliou A, Luty AJF, Cot M, Fievet N, Massougbodji A, Deloron P, Ndam TN (2015). Submicroscopic plasmodium falciparum infections are associated with maternal anemia, premature births, and low birth weight. Clin Infect Dis. 60(10):1481–1488.

Guyat HL, Snow RW (2004). Impact of malaria during pregnancy on low birth weight in SubSahara Africa. Clin Microbiol Rev. 17(4): 760-769.

Kementerian Kesehatan RI (2019). Situasi terkini perkembangan program peng-endalian malaria di Indonesia tahun 2018 (The latest situation in the development of the malaria control program in Indonesia in 2018). Jakarta: Indonesia.

Lawford HLS, Lee ACC, Kumar S, Liley HG, Bora S (2019). Establishing a conceptual framework of the impact of placental malaria on infant neuro-development. Int J Infect Dis 84(1): 54–65.

Lufele E, Umbers A, Ordi J, Kaius MO, Wangnapi R, Unger H, Tarongka N, Siba P, Mueller I, Robinson L, Roger-son S (2017). Risk factors and pregnancy outcomes associated with placental malaria in a prospective cohort of Papua New Guinean women. Malar

J. 16(427):1–10.

Mahande AM, Mahande MJ (2016). Prevalence of parasitic infections and associations with pregnancy complications and outcomes in northern Tanzania: a registry-based cross-sectional study. BMC Infect Dis. 16(78):1–9.

Murti B (2018) Prinsip dan metode riset epidemiologi. 5th edn. Surakarta: Pro-gram Studi Ilmu Kesehatan Masyarakat, Program Pascasarjana, Univer-sitas Sebelas Maret.

Ndeserua R, Juma A, Mosha D, Chilongola J (2015). Risk factors for placental malaria and associated adverse pregnancy outcomes in Rufiji, Tanzania: a hospital based cross sectional study. Afr Health Sci. 15(3): 810-818.

Omer SA, Noureldein AN, Eisa H, Abdel-rahim M, Idress HE, Abdelrazig AM, Adam I (2019). Impact of submicro-scopic plasmodium falciparum parasi-taemia on maternal anaemia and low birth weight in Blue Nile State, Sudan. J Trop Med (1):316-378,

Omer SA.,Idress HE, Adam I, Abdelrahim M, Noureldein AN, Abdelrazig AM, Elhassan MO, Sulaiman SM (2017). Placental malaria and its effect on pregnancy outcomes in Sudanese women from Blue Nile State. Malar J. 16(347): 1–8.

Padonou G, Le Port, A, Cottrell G, Guerra J, Choudat I, Rachas A, Bouscaillou J, Massougbodji A, Garcia A, Martin-Prevel Y (2014). Prematurity, intra-uterine growth retardation and low birth weight: Risk factors in a malariaendemic area in Southern Benin. Trans R Soc Trop Med Hyg. 108(2): 77–83.

Poespoprodjo JR, Fobia W, Kenangalem E, Lampah DA, Warikar N, Seal A, Mcgready R, Sugiarto P, Tjitra E, Anstey NM, Price RN (2008). Adverse pregnancy outcomes in an area where multidrug-resistant Plasmodium vivax and Plasmodium falciparum Infections Are Endemic. Clin Infect Dis. 46 (1):1–8.

Quanquin NM, Barres LG, Aliyari SR, Day NT, GeramiH, Fisher SJ, Kakuru A, Kamya MR, Havlir DV, Feeney M, Dorsey G, Cheng G, Gaw SL (2020). Gravidity-dependent associations between interferon response and birth weight in placental malaria. Malar J.


Rijken MJ, Mcgready R, Boel ME, Poespoprodjo R, Singh N, Syafruddin D, Rogerson S, Nosten F (2012). Malaria in pregnancy in the Asia-Pacific region. Lancet Infect Dis. 12(1):75-88.

Rudono, Dasuki D, Mukti AG (2005). Hu-bungan penyakit malaria pada ibu hamil dengan kejadian berat badan lahir rendah di daerah endemic malaria kabupaten Purworejo (The relationship between malaria in pregnant women and the incidence of low birth weight in malaria endemic areas, Purworejo district). Sains Kesehatan. 18(2): 221-235.

Stanisic DI, Moore KA, Baiwog F, Ura A, Clapham C, King CL, Siba PM, Beeson JG, Mueller I, Fowkes FJ, Rogerson SJ (2015). Risk factors for malaria and adverse birth outcomes in a prospective cohort of pregnant women resident in a high malaria transmission area of Papua New Guinea. Trans R Soc Trop Med Hyg. 109(5):313–324.

Uneke CJ (2007). Impact of placental Plasmodium falciparum malaria on pregnancy and perinatal outcome in sub-Saharan Africa. II: Effects of placental malaria on perinatal outcome; malaria and HIV. Yale J Biol Med. 80(3): 95–103.

Unger HW, Rosanas UA, Robinson LJ, Ome KM, Jally S, Umbers AJ, Pomat W, Mueller I, Kattenberg E, Rogerson SJ (2019). Microscopic and submicroscopic Plasmodium falcipa-rum infection, maternal anaemia and adverse pregnancy outcomes in Papua New Guinea: A cohort study. Malaria J, 18(1): 2-9.

Walther B, Miles DJC, Crozier S, Waight P, Palmero MS, Ojuola O, Touray E, Sande MVD, Whittle H, Jones SR, Flanagan KL (2010). Placental mala-ria is associated with reduced early life weight development of affected children independent of low birth weight. Malar J. 9(16):1–10.

World Health Organization (2019). World malaria report 2019. Geneva.


  • There are currently no refbacks.