The Impact of Malaria Severity, BMI, and Hemoglobin Levels on Cervical Length and Miscarriage Risk in First-Trimester Pregnancies

Introduction: Malaria in pregnancy is a significant public health issue in endemic regions, with implications for maternal and fetal health. This study examines the relationship between malaria severity, systemic health markers, and cervical length in first-trimester pregnancies, providing insights into their combined impact on miscarriage risk. Method: A cross-sectional study was conducted at KAIFA Ultrasound Center, involving 200 first-trimester pregnant women with laboratory confirmed malaria. Data on maternal age, BMI, hemoglobin levels, and malaria severity were collected. Cervical length was measured via transabdominal ultrasound. Statistical analyses included Pearson and Spearman correlations, one-way ANOVA, post-hoc tests, and logistic regression. Results: Higher malaria parasitemia levels were significantly associated with shorter cervical lengths (ANOVA F = 9.4, p < 0.001). Post-hoc analyses revealed significant differences between all parasitemia groups. BMI and hemoglobin levels were also associated with cervical length; obese women and those with hemoglobin <10 g/dL exhibited significantly shorter cervical lengths (ANOVA F = 6.8, p = 0.002 and F = 4.3, p = 0.01, respectively). Logistic regression identified cervical shortening (≤25 mm), BMI ≥ 25 kg/m2, and low hemoglobin as predictors of miscarriage. Conclusion: Malaria severity, high BMI, and anemia contribute to cervical shortening, increasing miscarriage risk. Integrating cervical length assessments, nutritional interventions, and malaria prevention into antenatal care can improve outcomes in malaria-endemic regions.