The choice of reference chart affects the strength of the association between malaria in pregnancy and small for gestational age: an individual participant data meta-analysis comparing the Intergrowth-21 with a Tanzanian birthweight chart
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The choice of reference chart affects the strength of the association between malaria in pregnancy and small for gestational age : an individual participant data meta-analysis comparing the Intergrowth-21 with a Tanzanian birthweight chart. / Mtove, George; Minja, Daniel T R; Abdul, Omari; Gesase, Samwel; Maleta, Kenneth; Divala, Titus H; Patson, Noel; Ashorn, Ulla; Laufer, Miriam K; Madanitsa, Mwayiwawo; Ashorn, Per; Mathanga, Don; Chinkhumba, Jobiba; Gutman, Julie R; Ter Kuile, Feiko O; Møller, Sofie Lykke; Bygbjerg, Ib C; Alifrangis, Michael; Theander, Thor; Lusingu, John P A; Schmiegelow, Christentze.
I: Malaria Journal, Bind 21, Nr. 1, 292, 2022.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - The choice of reference chart affects the strength of the association between malaria in pregnancy and small for gestational age
T2 - an individual participant data meta-analysis comparing the Intergrowth-21 with a Tanzanian birthweight chart
AU - Mtove, George
AU - Minja, Daniel T R
AU - Abdul, Omari
AU - Gesase, Samwel
AU - Maleta, Kenneth
AU - Divala, Titus H
AU - Patson, Noel
AU - Ashorn, Ulla
AU - Laufer, Miriam K
AU - Madanitsa, Mwayiwawo
AU - Ashorn, Per
AU - Mathanga, Don
AU - Chinkhumba, Jobiba
AU - Gutman, Julie R
AU - Ter Kuile, Feiko O
AU - Møller, Sofie Lykke
AU - Bygbjerg, Ib C
AU - Alifrangis, Michael
AU - Theander, Thor
AU - Lusingu, John P A
AU - Schmiegelow, Christentze
N1 - © 2022. The Author(s).
PY - 2022
Y1 - 2022
N2 - BACKGROUND: The prevalence of small for gestational age (SGA) may vary depending on the chosen weight-for-gestational-age reference chart. An individual participant data meta-analysis was conducted to assess the implications of using a local reference (STOPPAM) instead of a universal reference (Intergrowth-21) on the association between malaria in pregnancy and SGA.METHODS: Individual participant data of 6,236 newborns were pooled from seven conveniently identified studies conducted in Tanzania and Malawi from 2003-2018 with data on malaria in pregnancy, birthweight, and ultrasound estimated gestational age. Mixed-effects regression models were used to compare the association between malaria in pregnancy and SGA when using the STOPPAM and the Intergrowth-21 references, respectively.RESULTS: The 10th percentile for birthweights-for-gestational age was lower for STOPPAM than for Intergrowth-21, leading to a prevalence of SGASTOPPAM of 14.2% and SGAIG21 of 18.0%, p < 0.001. The association between malaria in pregnancy and SGA was stronger for STOPPAM (adjusted odds ratio (aOR) 1.30 [1.09-1.56], p < 0.01) than for Intergrowth-21 (aOR 1.19 [1.00-1.40], p = 0.04), particularly among paucigravidae (SGASTOPPAM aOR 1.36 [1.09-1.71], p < 0.01 vs SGAIG21 aOR 1.21 [0.97-1.50], p = 0.08).CONCLUSIONS: The prevalence of SGA may be overestimated and the impact of malaria in pregnancy underestimated when using Intergrowth-21. Comparing local reference charts to global references when assessing and interpreting the impact of malaria in pregnancy may be appropriate.
AB - BACKGROUND: The prevalence of small for gestational age (SGA) may vary depending on the chosen weight-for-gestational-age reference chart. An individual participant data meta-analysis was conducted to assess the implications of using a local reference (STOPPAM) instead of a universal reference (Intergrowth-21) on the association between malaria in pregnancy and SGA.METHODS: Individual participant data of 6,236 newborns were pooled from seven conveniently identified studies conducted in Tanzania and Malawi from 2003-2018 with data on malaria in pregnancy, birthweight, and ultrasound estimated gestational age. Mixed-effects regression models were used to compare the association between malaria in pregnancy and SGA when using the STOPPAM and the Intergrowth-21 references, respectively.RESULTS: The 10th percentile for birthweights-for-gestational age was lower for STOPPAM than for Intergrowth-21, leading to a prevalence of SGASTOPPAM of 14.2% and SGAIG21 of 18.0%, p < 0.001. The association between malaria in pregnancy and SGA was stronger for STOPPAM (adjusted odds ratio (aOR) 1.30 [1.09-1.56], p < 0.01) than for Intergrowth-21 (aOR 1.19 [1.00-1.40], p = 0.04), particularly among paucigravidae (SGASTOPPAM aOR 1.36 [1.09-1.71], p < 0.01 vs SGAIG21 aOR 1.21 [0.97-1.50], p = 0.08).CONCLUSIONS: The prevalence of SGA may be overestimated and the impact of malaria in pregnancy underestimated when using Intergrowth-21. Comparing local reference charts to global references when assessing and interpreting the impact of malaria in pregnancy may be appropriate.
U2 - 10.1186/s12936-022-04307-2
DO - 10.1186/s12936-022-04307-2
M3 - Journal article
C2 - 36224585
VL - 21
JO - Malaria Journal
JF - Malaria Journal
SN - 1475-2875
IS - 1
M1 - 292
ER -
ID: 322276420