Evaluation of HLA-G and Hematobiochemical levels and their association with malaria and miscarriage among pregnant women: A Ghanaian case-control study
8 affiliations
- 1Department of medical laboratory sciences, Faculty of health and Allied sciences, KAAF University, Gomoa Fetteh, Ghana
- 2UMR 261 MERIT, Université de Paris, Institut de Recherche pour le Développement (IRD), Paris, France
- 3Department of Molecular Medicine, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- 4Department of Microbiology and Immunology, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana
- 5Department of Medical Laboratory Technology, Central College of Science and Technology, Agona Swedru, Ghana
- 6Department of Parasitology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
- 7Department of Forensic Science, School of Biological Sciences, College of Agriculture and Natural Sciences, University of Cape Coast, Cape Coast, Ghana
- 8Department of Biomedical Science, School of Allied Health Sciences, University of Cape Coast, Cape Coast, Ghana
Abstract
Background: HLA-G (Human Leukocyte Antigen-G) is a non-classical molecule belonging to the major histocompatibility complex (MHC) class I family, located on chromosome 6 within the MHC region, which is pivotal in promoting immune tolerance. The immune-suppressive ability of Human Leukocyte Antigen (HLA-G) and its binding to fetal maternal interface predispose pregnant women to Plasmodium falciparum (Pf) infection and pregnancy loss, respectively. Alterations in hematological parameters may accelerate the severity of malaria infection. Limited data is available about the effects of malaria infection on hepatocytes and how this endangers the lives of the mother and the fetus due to liver injury. Thus, this study evaluated HLA-G and Hematobiochemical levels and their association with malaria infection and miscarriage among pregnant women in the Ghanaian population. Materials and Methods: This case-control study recruited forty-six (46) Pf-infected pregnant women and forty-six (46) Pf-uninfected pregnant women from the Bibiani Anhwiaso Bekwai Municipality, Ghana. A well-structured questionnaire was administered to obtain sociodemographic and clinical data from 21st December 2022–20th December 2023. 10 ml venous blood samples were collected from each participant for Pf parasite testing using the Pf HRP2 RDT test kit (CareStart TM Malaria PfHRP2/pLDH Ag RDT, Access Bio, Inc., USA), and the results were confirmed with microscopy. Hematobiochemical profile analyses were done using the Sysmex automated hematology and chemistry analyser. Plasma HLA-G levels were quantified using a sandwich ELISA (Maxisop ELISA plate), and their corresponding concentrations were determined. Results: The results shows a significant difference in the use of IPT-SP and Pf infection, with 31(67.4%) for Pf positive vs 18(39.1%) for Pf negative among those who were not on IPT-SP and 15(32.6%) for Pf positive vs 28(60.9%) for Pf negative for those who were on IPT-SP (p = 0.007)., Multivariate regression crude analysis shows increased ALT levels among the malaria-infected pregnant women [β = 7.091(95% CI = 1.563–32.182) p = 0.011] compared to the negative group. This finding was insignificant after adjusting for age, IPT-SP use and Trimester. ALP, on the other hand, shows significantly increased levels among the malaria-infected pregnant women compared to the malaria-negative pregnant women for both crude [β = 13.301(95% CI = 1.577–112.208) p = 0.017] and adjusted [β = 17.524(95% CI = 1.534–200.20), p = 0.02] analysis. In a comparative analysis, we found that GLR (G) and PLR (H) levels were significantly higher in participants with Pf infections compared to participants without Pf infection (p < 0.05). We also found that women with a history of miscarriage had considerably higher sHLA-G levels [50.14 (36.30–71.00) vs. 35.44(31.84–42.72)] than women with no history of miscarriage. Conclusion: Pf infection in pregnant Ghanaian women was associated with elevated ALP, GLR, and PLR, indicating hepatic dysfunction and systemic inflammation. The non-use of IPTp-SP among pregnant women was significantly associated with active Pf infection, highlighting the importance of chemoprophylaxis. Increased sHLA-G levels in women with miscarriage suggest an immunological link to pregnancy loss. Further prospective investigation of sHLA-G as a biomarker of adverse pregnancy outcome in malaria-endemic settings with a larger sample size is required.
Related
- The association of urinary xenoestrogens levels in pregnant women and their risk of missed miscarriage
- Joint Association of Parity and Spontaneous Miscarriage with Incident Cardiovascular Diseases
- The association between men working abroad and the health of their pregnant wives and newborns in Tajikistan. A secondary analysis of demographic and health survey data
- A comprehensive study on the association of personal air pollution exposure with thyroid hormones in pregnant women
- Prevalence of smartphone addiction and its association with anxiety and depression among pregnant women in Pakistan: A cross-sectional study
BibTeX
@article{kwakye2026evaluation,
title = {{Evaluation of HLA-G and Hematobiochemical levels and their association with malaria and miscarriage among pregnant women: A Ghanaian case-control study}},
author = {Richmond Kwakye and David Courtin and Samuel Asamoah Sakyi and Faustina Pappoe and Gideon Kwesi Nakotey and Naa Adjeley Frempong and Prince Amoah Barnie and Benjamin Amoani},
journal = {PLOS One},
year = {2026},
month = sep,
doi = {10.1371/journal.pone.0355847},
url = {https://doi.org/10.1371/journal.pone.0355847},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Evaluation of HLA-G and Hematobiochemical levels and their association with malaria and miscarriage among pregnant women: A Ghanaian case-control study
AU - Richmond Kwakye
AU - David Courtin
AU - Samuel Asamoah Sakyi
AU - Faustina Pappoe
AU - Gideon Kwesi Nakotey
AU - Naa Adjeley Frempong
AU - Prince Amoah Barnie
AU - Benjamin Amoani
PY - 2026
DA - 2026/09/10
JO - PLOS One
DO - 10.1371/journal.pone.0355847
UR - https://doi.org/10.1371/journal.pone.0355847
AB - Background: HLA-G (Human Leukocyte Antigen-G) is a non-classical molecule belonging to the major histocompatibility complex (MHC) class I family, located on chromosome 6 within the MHC region, which is pivotal in promoting immune tolerance. The immune-suppressive ability of Human Leukocyte Antigen (HLA-G) and its binding to fetal maternal interface predispose pregnant women to Plasmodium falciparum (Pf) infection and pregnancy loss, respectively. Alterations in hematological parameters may accelerate the severity of malaria infection. Limited data is available about the effects of malaria infection on hepatocytes and how this endangers the lives of the mother and the fetus due to liver injury. Thus, this study evaluated HLA-G and Hematobiochemical levels and their association with malaria infection and miscarriage among pregnant women in the Ghanaian population. Materials and Methods: This case-control study recruited forty-six (46) Pf-infected pregnant women and forty-six (46) Pf-uninfected pregnant women from the Bibiani Anhwiaso Bekwai Municipality, Ghana. A well-structured questionnaire was administered to obtain sociodemographic and clinical data from 21st December 2022–20th December 2023. 10 ml venous blood samples were collected from each participant for Pf parasite testing using the Pf HRP2 RDT test kit (CareStart TM Malaria PfHRP2/pLDH Ag RDT, Access Bio, Inc., USA), and the results were confirmed with microscopy. Hematobiochemical profile analyses were done using the Sysmex automated hematology and chemistry analyser. Plasma HLA-G levels were quantified using a sandwich ELISA (Maxisop ELISA plate), and their corresponding concentrations were determined. Results: The results shows a significant difference in the use of IPT-SP and Pf infection, with 31(67.4%) for Pf positive vs 18(39.1%) for Pf negative among those who were not on IPT-SP and 15(32.6%) for Pf positive vs 28(60.9%) for Pf negative for those who were on IPT-SP (p = 0.007)., Multivariate regression crude analysis shows increased ALT levels among the malaria-infected pregnant women [β = 7.091(95% CI = 1.563–32.182) p = 0.011] compared to the negative group. This finding was insignificant after adjusting for age, IPT-SP use and Trimester. ALP, on the other hand, shows significantly increased levels among the malaria-infected pregnant women compared to the malaria-negative pregnant women for both crude [β = 13.301(95% CI = 1.577–112.208) p = 0.017] and adjusted [β = 17.524(95% CI = 1.534–200.20), p = 0.02] analysis. In a comparative analysis, we found that GLR (G) and PLR (H) levels were significantly higher in participants with Pf infections compared to participants without Pf infection (p < 0.05). We also found that women with a history of miscarriage had considerably higher sHLA-G levels [50.14 (36.30–71.00) vs. 35.44(31.84–42.72)] than women with no history of miscarriage. Conclusion: Pf infection in pregnant Ghanaian women was associated with elevated ALP, GLR, and PLR, indicating hepatic dysfunction and systemic inflammation. The non-use of IPTp-SP among pregnant women was significantly associated with active Pf infection, highlighting the importance of chemoprophylaxis. Increased sHLA-G levels in women with miscarriage suggest an immunological link to pregnancy loss. Further prospective investigation of sHLA-G as a biomarker of adverse pregnancy outcome in malaria-endemic settings with a larger sample size is required.
SN - 1932-6203
ER -