Maternal Malaria and Malnutrition (M3) initiative, a pooled birth cohort of 13 pregnancy studies in Africa and the Western Pacific Holger W Unger, 1,2 Jordan E Cates, 3 Julie Gutman, 4 Valerie Briand, 5,6 Nadine Fievet, 5,6 Innocent Valea, 7,8 Halidou Tinto, 7,8 Umberto d’Alessandro, 9,10,11 Sarah H Landis, 12 Seth Adu-Afarwuah, 13 Kathryn G Dewey, 14 Feiko Ter Kuile, 15 Stephanie Dellicour, 15 Peter Ouma, 16 Laurence Slutsker, 4 Dianne J Terlouw, 17 Simon Kariuki, 16 John Ayisi, 16 Bernard Nahlen, 18 Meghna Desai, 4 Mwayi Madanitsa, 19 Linda Kalilani-Phiri, 15,19 Per Ashorn, 20,21 Kenneth Maleta, 19 Ivo Mueller, 22 Danielle Stanisic, 23 Christentze Schmiegelow, 24 John Lusingu, 24,25 Daniel Westreich, 3 Anna Maria van Eijk, 15 Steven Meshnick, 3 Stephen Rogerson 2 To cite: Unger HW, Cates JE, Gutman J, et al. Maternal Malaria and Malnutrition (M3) initiative, a pooled birth cohort of 13 pregnancy studies in Africa and the Western Pacific. BMJ Open 2016;6:e012697. doi:10.1136/bmjopen-2016- 012697 ▸ Prepublication history for this paper is available online. To view these files please visit the journal online (http://dx.doi.org/10.1136/ bmjopen-2016-012697). Received 17 May 2016 Accepted 8 November 2016 For numbered affiliations see end of article. Correspondence to Professor Stephen Rogerson; sroger@unimelb.edu.au ABSTRACT Purpose: The Maternal Malaria and Malnutrition (M3) initiative has pooled together 13 studies with the hope of improving understanding of malaria–nutrition interactions during pregnancy and to foster collaboration between nutritionists and malariologists. Participants: Data were pooled on 14 635 singleton, live birth pregnancies from women who had participated in 1 of 13 pregnancy studies. The 13 studies cover 8 countries in Africa and Papua New Guinea in the Western Pacific conducted from 1996 to 2015. Findings to date: Data are available at the time of antenatal enrolment of women into their respective parent study and at delivery. The data set comprises essential data such as malaria infection status, anthropometric assessments of maternal nutritional status, presence of anaemia and birth weight, as well as additional variables such gestational age at delivery for a subset of women. Participating studies are described in detail with regard to setting and primary outcome measures, and summarised data are available from each contributing cohort. Future plans: This pooled birth cohort is the largest pregnancy data set to date to permit a more definite evaluation of the impact of plausible interactions between poor nutritional status and malaria infection in pregnant women on fetal growth and gestational length. Given the current comparative lack of large pregnancy cohorts in malaria-endemic settings, compilation of suitable pregnancy cohorts is likely to provide adequate statistical power to assess malaria– nutrition interactions, and could point towards settings where such interactions are most relevant. The M3 cohort may thus help to identify pregnant women at high risk of adverse outcomes who may benefit from tailored intensive antenatal care including nutritional supplements and alternative or intensified malaria prevention regimens, and the settings in which these interventions would be most effective. INTRODUCTION It is estimated that each year over 125 million pregnant women residing in low-income and middle-income countries (LMICs) are at risk of infection with Plasmodium falciparum and P. vivax. 1 Malaria contributes to the high burden of maternal morbidity and mortality in these settings and may affect placental development and fetal growth. 2 Sequestration of P. falciparum parasites in the placenta has been associated with fetal growth restriction (FGR) and low birth weight (LBW, <2500 g), thus contributing to Strengths and limitations of this study ▪ This cohort pools data from 14 635 singleton, live birth pregnancies in women who participated in 1 of 13 pregnancy studies in areas with high burdens of malaria and undernutrition. ▪ The Maternal Malaria and Malnutrition (M3) pooled data set uses data collected at first ante- natal attendance and at time of delivery. ▪ The data set comprises essential information on malaria infection status, maternal anthropometric indicators of undernutrition, presence of mater- nal anaemia, neonatal anthropometrics and ges- tational age at delivery, among others. ▪ The main limitation is the heterogeneity in avail- ability of certain variables due to study design and data collection differences between studies. Unger HW, et al. BMJ Open 2016;6:e012697. doi:10.1136/bmjopen-2016-012697 1 Open Access Cohort profile