Evidence map›Paper›PMID 41476285›Full record

ArticleMalaria journal2025

VAR2CSA-specific IgG and IgM antibodies are markers of exposure and protection against adverse malaria pregnancy outcomes.

Akachukwu M Onwuka, Elizabeth H Aitken, Wina Hasang, Mwayiwawo Madanitsa, Victor Mwapasa, Kamija Phiri, Feiko O Ter Kuile, Stephen J Rogerson

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Article in Malaria journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

8 authors.

Akachukwu M OnwukaDepartment of Infectious Diseases, The Peter Doherty Institute of Infection and Immunity, University of Melbourne, Melbourne, VIC, 3000, Australia.
Elizabeth H AitkenDepartment of Infectious Diseases, The Peter Doherty Institute of Infection and Immunity, University of Melbourne, Melbourne, VIC, 3000, Australia.
Wina HasangDepartment of Infectious Diseases, The Peter Doherty Institute of Infection and Immunity, University of Melbourne, Melbourne, VIC, 3000, Australia.
Mwayiwawo MadanitsaDepartment of Clinical Sciences, Academy of Medical Sciences, Malawi University of Science and Technology, Thyolo, Malawi.
Victor MwapasaDepartment of Epidemiology and Biostatistics, School of Global and Public Health, Kamuzu University of Health Sciences, Blantyre, Malawi.
Kamija PhiriTraining and Research Unit of Excellence, Blantyre, Malawi.
Feiko O Ter KuileDepartment of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK.
Stephen J RogersonDepartment of Infectious Diseases, The Peter Doherty Institute of Infection and Immunity, University of Melbourne, Melbourne, VIC, 3000, Australia. sroger@unimelb.edu.au.ORCID http://orcid.org/0000-0003-4287-1982

Funding

National Health and Medical Research Council 2020606
6 · The paper itself

Abstract

backgroundPlacental malaria is caused by the binding of the Plasmodium falciparum erythrocyte membrane protein 1 (PfEMP1) protein VAR2CSA, found on the surface of infected erythrocytes, to placental tissue. Complications include maternal anaemia, low birth weight, small for gestational age and preterm delivery. Acquisition of antibodies against VAR2CSA during pregnancy has been linked to immunity against infection.

methodsPregnant Malawian women were enrolled at their first antenatal care visit at 16-28 weeks' gestation into a trial of malaria prevention. Women with malaria infection at enrolment (n = 321) or any later point in pregnancy (n = 145) were selected. The IgG and IgM plasma levels against the VAR2CSA DBL1X-ID2a domain were measured at enrolment and delivery. Associations between the DBL1X-ID2a VAR2CSA-specific IgG and IgM antibody levels at enrolment or delivery and low birth weight, small for gestational age, maternal anaemia at delivery, and preterm delivery were assessed using logistic regression with confounder adjustment.

resultWomen with malaria infection at enrolment had higher antibody levels to DBL1X-ID2a than uninfected women, and these declined from enrolment to delivery. There were no significant associations between the IgG antibody level measured at enrolment and the birth outcomes of interest, but the IgG antibody level at delivery in women uninfected at enrolment was associated with a lower risk of low birth weight, adjusted odds ratio (aOR) 0.43 (95% CI 0.19-0.97) p = 0.04. Additionally, in women infected at enrolment, one log higher IgM antibodies to DBL1X-ID2a VAR2CSA at enrolment were associated with a significant 23% decrease in maternal anaemia at delivery, aOR 0.77 (95% CI 0.60-0.99), p = 0.04.

conclusionVAR2CSA-specific IgG and IgM antibodies are markers of malaria infection and protection against placental malaria outcomes.

Indexed as

Antibodies, ProtozoanAntigens, ProtozoanImmunoglobulin GImmunoglobulin MMalaria, FalciparumPregnancy Complications, ParasiticAdolescentAdultBiomarkersFemaleHumansInfant, NewbornMalawiPlasmodium falciparumPregnancyPregnancy OutcomeAntibodies, ProtozoanAntigens, ProtozoanBiomarkersImmunoglobulin GImmunoglobulin MVAR2CSA protein, Plasmodium falciparumLow birth weightMaternal anaemiaPlacental malariaPreterm deliverySmall for gestational ageVAR2CSA

Identifiers

PMID41476285
PMCPMC12866454

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.