Placental Malaria Parasitaemia and Neonatal outcome at Owerri Imo State Nigeria

Introduction: Malaria remains endemic in many tropical African countries and continues to pose a significant public health challenge. Pregnant women and children are particularly vulnerable to malaria infection due to pregnancy-related immunological changes, with placental malaria being associated with adverse maternal and neonatal outcomes. Objective: This study aimed to determine the correlation between placental malaria parasitaemia and neonatal outcomes among term babies delivered in Owerri, the capital city of Imo State, Nigeria. Methodology: This was a descriptive correlational study conducted among consenting term parturients who delivered at the Labour and Delivery units of the Federal Teaching Hospital, Owerri; the Claretian University of Nigeria Hospital; and the Holy Family Sisters of the Needy Hospital, all located in Owerri, Imo State. Women with pre-existing medical conditions such as hypertension, cardiac or renal disease, diabetes mellitus, sickle cell anaemia, retroviral disease, as well as preterm parturients, were excluded.   Data were obtained using interviewer-administered questionnaires and patients’ case notes to collect information on socio-demographic characteristics, parity, gestational age, antenatal clinic attendance, use of intermittent preventive treatment (IPT) and insecticide-treated nets (ITNs). Immediately after delivery, placental blood samples were obtained from the maternal surface of the placenta for malaria parasite detection. Neonatal heel-prick blood samples were collected for malaria parasitaemia. In contrast, cord blood samples were used to estimate neonatal packed cell volume. Neonatal outcome measures assessed included birth weight, Apgar scores, jaundice, malaria parasitaemia, packed cell volume, and perinatal mortality. Data were analyzed using Chi-square and Fisher’s exact with statistical significance set at p ≤ 0.05.   Results/Findings: Out of 431 term parturients initially assessed, 400 were included in the final analysis. The prevalence of maternal peripheral malaria and placental malaria parasitaemia were 69% (276/400) and 14.0% (56/400) respectively. Placental malaria parasitaemia showed a statistically significant correlation with neonatal malaria parasitaemia (p =0.0001), neonatal anaemia (p = 0.010), low birth weight (p = 0.0001) and neonatal mortality (p = 0.002). There was no significant association with Apgar scores (p = 0.425). Recommendations: Malaria prevention and control strategies should be further strengthened during pregnancy, with emphasis on consistent use of IPT and insecticide-treated nets, early antenatal booking, and routine screening for malaria to reduce placental infection and its adverse neonatal consequences. Contributions to Knowledge: This study provided local epidemiological evidence that placental malaria parasitaemia remains relatively common in Owerri and significantly affects neonatal outcomes. It reinforces the role of placental malaria as a contributor to neonatal morbidity. It adds to existing Nigerian data supporting intensified malaria control measures during pregnancy.