Malaria

Abstract

Pregnant women are particularly vulnerable to malaria. Infection during pregnancy carries substantial risks to the pregnant woman as well as to the pregnancy and fetus/newborn. Maternal consequences depend on the underlying transmission setting and include severe anemia, cerebral malaria, respiratory distress, kidney failure, and even death. During pregnancy, the microvasculature of the intervillous space within the placenta becomes a novel privileged site for attachment of infected erythrocytes. This adherence triggers recruitment of an inflammatory infiltrate that damages the trophoblast. This results in adverse pregnancy complications such as preterm birth, fetal growth restriction, and stillbirth. Given the myriad potentially serious complications for both the pregnant woman and the fetus, prevention of malaria during pregnancy is critical. The World Health Organization recommends two prevention strategies in areas where malaria is endemic: vector control and chemoprophylaxis. Following successful treatment of malaria during pregnancy, fetal growth surveillance is recommended for the duration of the pregnancy.