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Malaria
Malaria in pregnant women
Malaria infection during pregnancy is a significant public health problem
with substantial risks for the pregnant woman, her fetus, and the
newborn child. Malaria-associated maternal illness and low birth weight
is mostly the result of Plasmodium falciparum infection and occurs
predominantly in Africa.
The symptoms and complications of malaria in pregnancy vary
according to malaria transmission intensity in the given geographical
area, and the individual’s level of acquired immunity.
High-transmission settings
In high-transmission settings, where levels of acquired immunity tend to
be high, P. falciparum infection is usually asymptomatic in pregnancy.
Yet, parasites may be present in the placenta and contribute to maternal
anaemia even in the absence of documented peripheral parasitaemia.
Both maternal anaemia and placental parasitaemia can lead to low birth
weight, which is an important contributor to infant mortality. In high-
transmission settings, the adverse effects of P. falciparum infection in
pregnancy are most pronounced for women in their first pregnancy.
Low-transmission settings
In low-transmission settings, where women of reproductive age have
relatively little acquired immunity to malaria, malaria in pregnancy is
associated with anaemia, an increased risk of severe malaria, and it
may lead to spontaneous abortion, stillbirth, prematurity and low birth
weight. In such settings, malaria affects all pregnant women, regardless
of the number of times they have been pregnant.
Infections with P. vivax
Infection with P. vivax , as with P. falciparum, leads to chronic anaemia
and placental malaria infection, reducing the birth weight and increasing
the risk of neonatal death. For women in their first pregnancy, the
reduction in birth weight is approximately two thirds of what is
associated with P. falciparum, but with P. vivax the effect appears to
increase with successive pregnancies.
WHO recommends the following package of interventions for the
prevention and treatment of malaria during pregnancy:
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8/19/2019 WHO _ Malaria in Pregnant Women
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2/28/2016 WHO | Malaria in pregnant women
http://www.who.int/malaria/areas/high_risk_groups/pregnancy/en/#
use of long-lasting insecticidal nets (LLINs);
in areas of stable malaria transmission of sub-Saharan Africa,intermittent preventive treatment in pregnancy (IPTp) withsulfadoxine-pyrimethamine (SP);
prompt diagnosis and effective treatment of malaria infections.
Intermittent preventive treatment in pregnancyIPTp reduces maternal malaria episodes, maternal anaemia, placental
parasitaemia, low birth weight, and neonatal mortality. Furthermore, all
pregnant women should receive iron and folic acid supplementation as a
part of routine antenatal care.
Read more on Intermittent preventive treatment in pregnancy (IPTp)
Last update: 25 April 2015
Key documents
Guidelines for the treatment of malaria, third edition (2015)
WHO policy brief for the implementation of intermittent preventivetreatment of malaria in pregnancy using sulfadoxine-pyrimethamine(IPTp-SP), April 2013 (revised January 2014)
Complete list of related documents
Related links
Preventive therapies for malaria
Intermittent preventive treatment
for pregnant women (IPTp)
Malaria in infants
Malaria in children under five
All high-risk groups
WHO Evidence Review Group: intermittent preventive treatment of malaria in pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP),July 2012pdf, 342kb
http://www.who.int/entity/malaria/mpac/sep2012/iptp_sp_erg_meeting_report_july2012.pdf?ua=1http://www.who.int/entity/malaria/areas/high_risk_groups/en/index.htmlhttp://www.who.int/entity/malaria/areas/high_risk_groups/children/en/index.htmlhttp://www.who.int/entity/malaria/areas/high_risk_groups/infants/en/index.htmlhttp://www.who.int/entity/malaria/areas/preventive_therapies/pregnancy/en/index.htmlhttp://www.who.int/entity/malaria/areas/preventive_therapies/en/index.htmlhttp://www.who.int/entity/malaria/publications/high_risk_groups/en/index.htmlhttp://www.who.int/entity/malaria/publications/atoz/policy_brief_iptp_sp_policy_recommendation/en/index.htmlhttp://www.who.int/entity/malaria/publications/atoz/9789241549127/en/index.htmlhttp://www.who.int/entity/malaria/areas/preventive_therapies/pregnancy/en/index.html