Abstract:
n malaria-endemic regions, infection with the malaria parasite Plasmodium
during pregnancy has been identified as a key modifiable factor in preterm
birth, the delivery of low-birthweight infants, and stillbirth. Compared with
their nonpregnant peers, pregnant persons are at higher risk for malaria
infection. Malaria infection can occur at any time during pregnancy, with
negative effects for the pregnant person and the fetus, depending on the
trimester in which the infection is contracted. Pregnant patients who are
younger, in their first or second pregnancy, and those coinfected with
human immunodeficiency virus are at increased risk for malaria. Common
infection prevention measures during pregnancy include the use of
insecticide-treated bed nets and the use of intermittent preventive
treatment with monthly doses of antimalarials, beginning in the second
trimester in pregnant patients in endemic areas. In all trimesters,
artemisinin-combination therapies are the first-line treatment for uncomplicated falciparum malaria, similar to treatment in nonpregnant adults. The World Health Organization
recently revised its recommendations, now listing the specific medication artemether-lumefantrine as first-line
treatment for uncomplicated malaria in the first trimester. While strong prevention and detection methods exist,
use of these techniques remains below global targets. Ongoing work on approaches to treatment and prevention
of malaria during pregnancy remains at the forefront of global maternal child health research.
