Impact of Nutritional Status and Placental Malaria Infection on Pregnancy Outcome in a Population of Nigerian Maternal-Infant Dyads

Author

Shirley F. Delair, University of Nebraska Medical CenterFollow

ORCID ID

0000-0002-5663-3857

Graduation Date

Spring 5-4-2024

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Programs

Medical Sciences Interdepartmental Area

First Advisor

Stephen Obaro

Second Advisor

Corrine Hanson

Third Advisor

Jane Meza

Fourth Advisor

Lani Zimmerman

Abstract

Nigeria is the most populous country in Africa and accounts for one-quarter of the newborn mortality on the continent. Most newborn deaths are from prematurity (33%), infections (33%), and intrapartum complications (31%). Using an adapted analytical framework for the study of child survival in developing countries, this dissertation aimed to look at the pregnancy outcome of a population of Nigerian women and their offspring by looking at proximate determinants of health from nutritional status and environmental conditions. In Chapter 1, we characterized the micronutrients of the mother-infant dyads, looking specifically at concentrations of vitamin D and its metabolites. In Chapter 2, we looked at omega-3 fatty acids derived specialized pro-resolving mediators (SPMs). Finally, in Chapter 3, we characterized the prevalence of placenta malaria infection in a population of asymptomatic pregnant women in an endemic malaria region by looking at the presence of different Plasmodium species. Descriptive statistics were used. Spearman correlation was used to compare continuous variables, Mann-Whitney for dichotomous variables, and Kruskal-Wallis for two or more groups. Salient findings in Chapter 1 were: high cord percent 3-epi-25(OH)D₃ levels were positively associated with newborn evaluation for sepsis (p = 0.036) while maternal and cord 25(OH)D and 24,25(OH)₂D₃ levels were not. Further studies are needed to reproduce our findings and better understand the biology behind our observed association; in Chapter 2. maternal Nigerian RvD1 and RvD2 levels were significantly lower than that of the US cohort (p = 0.002 and p = 0.004, respectively). Maternal Nigerian RvD2 was negatively associated with maternal BMI and newborn length. (r= -0.288; p+ 0.033, r= -0.281; p = 0.028, respectively). Studies are needed in populations with more different diets and supplementation habits to understand the biology behind these SPM dynamics better. In Chapter 3, we report the presence of P. knowlesi in the African region in mixed placental malarial infections in asymptomatic pregnant women. This finding highlights the need to use PCR assays to characterize single and mixed infections better. A strong research collaborative team with our country partner and alignment of research priorities will help us continue to explore our research findings.

Comments

2024 Copyright, the authors

Recommended Citation

Delair, Shirley F., "Impact of Nutritional Status and Placental Malaria Infection on Pregnancy Outcome in a Population of Nigerian Maternal-Infant Dyads" (2024). Theses & Dissertations. 816.
https://digitalcommons.unmc.edu/etd/816