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Infection and Immunity, January 2003, p. 267-270, Vol. 71, No. 1
0019-9567/03/$08.00+0     DOI: 10.1128/IAI.71.1.267-270.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.

Placental Tumor Necrosis Factor Alpha but Not Gamma Interferon Is Associated with Placental Malaria and Low Birth Weight in Malawian Women

Stephen J. Rogerson,1,2,3* Heidi C. Brown,4 Elena Pollina,5 Elizabeth T. Abrams,6 Eyob Tadesse,7 Valentino M. Lema,7 and Malcolm E. Molyneux1,2

Malawi-Liverpool-Wellcome Trust Clinical Research Programme,1 Department of Obstetrics and Gynaecology, College of Medicine, University of Malawi, Blantyre, Malawi,7 School of Tropical Medicine, University of Liverpool, Liverpool,2 Nuffield Department of Clinical Laboratory Sciences, The John Radcliffe Hospital, Oxford,4 Department of Histopathology, Kings College Hospital, London, United Kingdom,5 Department of Medicine (RMH/WH), University of Melbourne, Melbourne, Victoria, Australia,3 Department of Anthropology, University of Michigan, Ann Arbor, Michigan6

Received 24 June 2002/ Returned for modification 26 August 2002/ Accepted 4 October 2002

Malaria in pregnancy predisposes to maternal anemia and low birth weight (LBW). We examined the possible roles of the cytokines tumor necrosis factor alpha (TNF-{alpha}) and gamma interferon (IFN-{gamma}) in these adverse outcomes. We measured cytokine concentrations in placental, peripheral, and cord blood plasma in relation to malaria parasitemia and placental monocyte accumulation in 276 Malawian women. Maternal hemoglobin concentration, human immunodeficiency virus status, and infant birth weight were determined. Concentrations of TNF-{alpha} in placental blood were correlated with densities of Plasmodium falciparum-infected erythrocytes (P < 0.0001) and of intervillous monocyte infiltrates (P < 0.0001) on placental histology. Peripheral blood TNF-{alpha} concentrations were relatively low and were weakly associated with malaria. TNF-{alpha} concentrations were higher in placental blood, where they were strongly associated with malaria. Placental plasma TNF-{alpha} levels were higher in women who had LBW babies (P = 0.0027), women with febrile symptoms (P < 0.0001), and teenage mothers (P = 0.04) than in other women. The presence of TNF-{alpha} in cord blood was not associated with malaria infection. IFN-{gamma} levels were infrequently elevated, and elevated IFN-{gamma} levels were not associated with poor pregnancy outcomes. Placental production of TNF-{alpha}, but not of IFN-{gamma}, may be implicated in impaired fetal growth in Malawian women.

* Corresponding author. Mailing address: University of Melbourne, Department of Medicine (RMH/WH), Post Office, Royal Melbourne Hospital, Parkville, VIC 3050, Australia. Phone: 61 3 8344 3259. Fax: 61 3 9347 1863. E-mail: sroger{at}unimelb.edu.au.

Editor: W. A. Petri, Jr.

Infection and Immunity, January 2003, p. 267-270, Vol. 71, No. 1
0019-9567/03/$08.00+0     DOI: 10.1128/IAI.71.1.267-270.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.



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