Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2017 Jun 1;7(6):a025551.
doi: 10.1101/cshperspect.a025551.

Malaria during Pregnancy

Michal Fried  1 , Patrick E Duffy  1
Affiliations
Review

Malaria during Pregnancy

Michal Fried et al. Cold Spring Harb Perspect Med. .

Abstract

One hundred and twenty-five million women in malaria-endemic areas become pregnant each year (see Dellicour et al. PLoS Med7: e1000221 [2010]) and require protection from infection to avoid disease and death for themselves and their offspring. Chloroquine prophylaxis was once a safe approach to prevention but has been abandoned because of drug-resistant parasites, and intermittent presumptive treatment with sulfadoxine-pyrimethamine, which is currently used to protect pregnant women throughout Africa, is rapidly losing its benefits for the same reason. No other drugs have yet been shown to be safe, tolerable, and effective as prevention for pregnant women, although monthly dihydroartemisinin-piperaquine has shown promise for reducing poor pregnancy outcomes. Insecticide-treated nets provide some benefits, such as reducing placental malaria and low birth weight. However, this leaves a heavy burden of maternal, fetal, and infant morbidity and mortality that could be avoided. Women naturally acquire resistance to Plasmodium falciparum over successive pregnancies as they acquire antibodies against parasitized red cells that bind chondroitin sulfate A in the placenta, suggesting that a vaccine is feasible. Pregnant women are an important reservoir of parasites in the community, and women of reproductive age must be included in any elimination effort, but several features of malaria during pregnancy will require special consideration during the implementation of elimination programs.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Malaria during pregnancy features several unique host–parasite interactions that require special attention for elimination strategies. Although malaria is more common in pregnant women than other adults, it is difficult to diagnose and therefore to control. The few drugs known to be safe during pregnancy are losing efficacy to drug-resistant Plasmodium falciparum parasites, and the use of new drugs or other interventions is hindered by concerns for fetal safety. Based on the knowledge of malaria immunity during pregnancy, vaccine approaches appear promising for the control of PM, but first-generation candidates are only now entering clinical trials and it is unclear whether these products will interrupt malaria transmission in pregnant women.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Abrams ET, Brown H, Chensue SW, Turner GD, Tadesse E, Lema VM, Molyneux ME, Rochford R, Meshnick SR, Rogerson SJ. 2003. Host response to malaria during pregnancy: Placental monocyte recruitment is associated with elevated β chemokine expression. J Immunol 170: 2759–2764. - PubMed
    1. Achur RN, Valiyaveettil M, Alkhalil A, Ockenhouse CF, Gowda DC. 2000. Characterization of proteoglycans of human placenta and identification of unique chondroitin sulfate proteoglycans of the intervillous spaces that mediate the adherence of Plasmodium falciparum–infected erythrocytes to the placenta. J Biol Chem 275: 40344–40356. - PubMed
    1. Aitken EH, Mbewe B, Luntamo M, Maleta K, Kulmala T, Friso MJ, Fowkes FJ, Beeson JG, Ashorn P, Rogerson SJ. 2010. Antibodies to chondroitin sulfate A-binding infected erythrocytes: Dynamics and protection during pregnancy in women receiving intermittent preventive treatment. J Infect Dis 201: 1316–1325. - PubMed
    1. Alkhalil A, Achur RN, Valiyaveettil M, Ockenhouse CF, Gowda DC. 2000. Structural requirements for the adherence of Plasmodium falciparum–infected erythrocytes to chondroitin sulfate proteoglycans of human placenta. J Biol Chem 275: 40357–40364. - PubMed
    1. Andrews KT, Klatt N, Adams Y, Mischnick P, Schwartz-Albiez R. 2005. Inhibition of chondroitin-4-sulfate-specific adhesion of Plasmodium falciparum–infected erythrocytes by sulfated polysaccharides. Infect Immun 73: 4288–4294. - PMC - PubMed

MeSH terms

LinkOut - more resources