Pregnancy and malaria: The perfect storm

Stephen J. Rogerson, Holger W. Unger

Research output: Contribution to journalReview articlepeer-review

Abstract

Purpose of review Malaria in pregnancy continues to exert a toll on pregnant women and their offspring.

Recent findings The burden of Plasmodium falciparum infection is especially large in Africa, and new data show lasting effects of maternal infection on the infant's neurocognitive development. Elsewhere, P. vivax infection causes relapsing infections that are challenging to prevent. Infection in first trimester of pregnancy is an area of increasing focus, and its adverse effects on pregnancy outcome are increasingly recognised. First-trimester infection is common and frequently acquired prior to conception. Although newer rapid diagnostic tests still have limited sensitivity, they may be useful in detection of early pregnancy malaria for treatment. Artemisinin-based combination therapies are efficacious in later pregnancy but have yet to be recommended in first trimester because of limited safety data. In Africa, intermittent preventive treatment in pregnancy (IPTp) with monthly sulfadoxine-pyrimethamine improves pregnancy outcomes, but sulfadoxine-pyrimethamine resistance is worsening. The alternative, IPTp with dihydroartemisinin-piperaquine, has greater antimalarial efficacy, but does not appear to improve pregnancy outcomes, because sulfadoxine-pyrimethamine has poorly understood nonmalarial benefits on birthweight. 

Summary Novel IPTp regimens must be combined with interventions to strengthen protection from malaria infection acquired before and in early pregnancy.

Original languageEnglish
Pages (from-to)410-416
Number of pages7
JournalCurrent Opinion in Infectious Diseases
Volume35
Issue number5
DOIs
Publication statusPublished - 1 Oct 2022

Fingerprint

Dive into the research topics of 'Pregnancy and malaria: The perfect storm'. Together they form a unique fingerprint.

Cite this