Malaria in Pregnancy: An Unrecognized Risk Factor for Neuropsychiatric Disease in Offspring?

Abstract

The in vitro environment has a profound effect on offspring neurodevelopment. Insults to the foetus during pregnancy can disrupt neurodevelopmental processes culminating in neurochemical and behavioural abnormalities. A growing body of evidence supports a role for maternal infection in precipitating neuropsychiatric disease in offspring. Since ~60% of pregnancies globally are at risk of malaria infection annually, we hypothesize that in utero exposure to malaria in pregnancy (MIP) may be a neglected risk factor for mental illness. We propose that the host response to infection makes an important contribution to this risk. MIP may mediate neuropathology via immune activation and inflammation in the placenta and consequent dysregulation of processes critical to fetal neurodevelopment including cerebral angiogenesis, neurogenesis, synaptic pruning, and neurochemical regulation.