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

George Mtove; Daniel T R Minja; Omari Abdul; Samwel Gesase; Kenneth Maleta; Titus H Divala; Noel Patson; Ulla Ashorn; Miriam K Laufer; Mwayiwawo Madanitsa; Per Ashorn; Don Mathanga; Jobiba Chinkhumba; Julie R Gutman; Feiko O Ter Kuile; Sofie Lykke Møller; Ib C Bygbjerg; Michael Alifrangis; Thor Theander; John P A Lusingu; Christentze Schmiegelow

doi:10.1186/s12936-022-04307-2

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

George Mtove^*, Daniel T R Minja, Omari Abdul, Samwel Gesase, Kenneth Maleta, Titus H Divala, Noel Patson, Ulla Ashorn, Miriam K Laufer, Mwayiwawo Madanitsa, Per Ashorn, Don Mathanga, Jobiba Chinkhumba, Julie R Gutman, Feiko O Ter Kuile, Sofie Lykke Møller, Ib C Bygbjerg, Michael Alifrangis, Thor Theander, John P A LusinguChristentze Schmiegelow

^*Corresponding author af dette arbejde

Afdeling for Infektionssygdomme

1 Citationer (Scopus)

Abstract

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.

Originalsprog	Engelsk
Artikelnummer	292
Tidsskrift	Malaria Journal
Vol/bind	21
Udgave nummer	1
ISSN	1475-2875
DOI	https://doi.org/10.1186/s12936-022-04307-2
Status	Udgivet - 12 okt. 2022

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10.1186/s12936-022-04307-2

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Citationsformater

Mtove, G., Minja, D. T. R., Abdul, O., Gesase, S., Maleta, K., Divala, T. H., Patson, N., Ashorn, U., Laufer, M. K., Madanitsa, M., Ashorn, P., Mathanga, D., Chinkhumba, J., Gutman, J. R., Ter Kuile, F. O., Møller, S. L., Bygbjerg, I. C., Alifrangis, M., Theander, T., ... Schmiegelow, C. (2022). 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. Malaria Journal, 21(1), Artikel 292. https://doi.org/10.1186/s12936-022-04307-2

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 et al.
I: Malaria Journal, Bind 21, Nr. 1, 292, 12.10.2022.

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

Mtove, G, Minja, DTR, Abdul, O, Gesase, S, Maleta, K, Divala, TH, Patson, N, Ashorn, U, Laufer, MK, Madanitsa, M, Ashorn, P, Mathanga, D, Chinkhumba, J, Gutman, JR, Ter Kuile, FO, Møller, SL, Bygbjerg, IC, Alifrangis, M, Theander, T, Lusingu, JPA & Schmiegelow, C 2022, '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', Malaria Journal, bind 21, nr. 1, 292. https://doi.org/10.1186/s12936-022-04307-2

Mtove G, Minja DTR, Abdul O, Gesase S, Maleta K, Divala TH et al. 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. Malaria Journal. 2022 okt. 12;21(1):292. doi: 10.1186/s12936-022-04307-2

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title = "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",

abstract = "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.",

keywords = "Birth Weight, Female, Fetal Growth Retardation, Gestational Age, Humans, Infant, Newborn, Infant, Small for Gestational Age, Malaria/epidemiology, Pregnancy, Tanzania/epidemiology",

author = "George Mtove and Minja, {Daniel T R} and Omari Abdul and Samwel Gesase and Kenneth Maleta and Divala, {Titus H} and Noel Patson and Ulla Ashorn and Laufer, {Miriam K} and Mwayiwawo Madanitsa and Per Ashorn and Don Mathanga and Jobiba Chinkhumba and Gutman, {Julie R} and {Ter Kuile}, {Feiko O} and M{\o}ller, {Sofie Lykke} and Bygbjerg, {Ib C} and Michael Alifrangis and Thor Theander and Lusingu, {John P A} and Christentze Schmiegelow",

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year = "2022",

month = oct,

day = "12",

doi = "10.1186/s12936-022-04307-2",

language = "English",

volume = "21",

journal = "Malaria Journal",

issn = "1475-2875",

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number = "1",

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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

PY - 2022/10/12

Y1 - 2022/10/12

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.

KW - Birth Weight

KW - Female

KW - Fetal Growth Retardation

KW - Gestational Age

KW - Humans

KW - Infant, Newborn

KW - Infant, Small for Gestational Age

KW - Malaria/epidemiology

KW - Pregnancy

KW - Tanzania/epidemiology

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U2 - 10.1186/s12936-022-04307-2

DO - 10.1186/s12936-022-04307-2

M3 - Journal article

C2 - 36224585

SN - 1475-2875

VL - 21

JO - Malaria Journal

JF - Malaria Journal

IS - 1

M1 - 292

ER -