Association of malaria parasitaemia and cytomegalovirus infection with serum interferon-γ levels among women with spontaneous abortion: a hospital-based cross-sectional study in Kano, North-West Nigeria

<title>Abstract</title> <p>Background Malaria and cytomegalovirus (CMV) infections have been implicated in adverse pregnancy outcomes, but their relationship with immune activation during spontaneous abortion remains incompletely understood. This study investigated the association of malaria parasitaemia and CMV infection with serum interferon-gamma (IFN-γ) concentrations among women with spontaneous abortion in Kano, North-West Nigeria. Methods A hospital-based cross-sectional study was conducted among 91 women with spontaneous abortion at two tertiary hospitals in Kano, Nigeria. Malaria parasitaemia was detected by microscopy, anti-CMV IgM antibodies and serum IFN-γ concentrations were measured by ELISA, and CMV DNA was detected by qPCR in IgM-positive samples. Associations were assessed using chi-square tests, Mann–Whitney U and multivariable logistic regression (p &lt; 0.05). Results Malaria parasitaemia was detected in 19/91 (20.9%) participants, while 11/91 (12.1%) were CMV IgM-seropositive, of whom 3/11 (27.3%) had detectable CMV DNA. Women from monogamous households had lower odds of malaria parasitaemia than those from polygamous households (AOR = 0.28, 95% CI: 0.10–0.82; p = 0.021). The median serum IFN-γ concentration was 0.969 pg/mL (IQR: 0.803–1.095). Serum IFN-γ concentrations were higher in women with malaria parasitaemia (median: 1.067 vs. 0.898 pg/mL; p = 0.007) and CMV IgM seropositivity (median: 1.067 vs. 0.942 pg/mL; p = 0.014). Conclusion Malaria parasitaemia and CMV IgM seropositivity were associated with higher serum IFN-γ concentrations among women with spontaneous abortion. These findings highlight the importance of strengthening infection prevention, early diagnosis, and appropriate clinical management during pregnancy in malaria-endemic settings. Clinical trial number: Not applicable</p>