An overview of malaria in pregnancy
Open accessAbstract
One hundred twenty-five million pregnant women are at risk for contracting malaria, a preventable cause of maternal and infant morbidity and death. Malaria parasites contribute to adverse pregnancy and birth outcomes due to their preferential accumulation in placental intervillous spaces. Pregnant women are particularly vulnerable to malaria infections, and malaria infections during pregnancy put their fetuses at risk. Malaria in pregnancy is associated with anemia, stillbirth, low birth weight and maternal and fetal death. We review the challenges to diagnosing malaria in pregnancy, as well as strategies to prevent and treat malaria in pregnancy. Finally, we discuss the current gaps in knowledge and potential areas for continued research.
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In pregnancy-associated malaria, P. falciparum attaches to the placenta, and infected red blood cells attach to chondroitin sulfate A and other placental receptors, leading to inflammation, fibrosis in the intervillous space, and impaired placental function.
“In pregnancy-associated malaria, P.falciparum is the main causative agent, attaching to the placenta and causing placental malaria. The infected red blood cells attach to chondroitin sulfate A (CSA) and other placental receptors, leading to inflammation, fibrosis in the intervillous space, and impaired placental function.”
From Current update on malaria in pregnancy: a systematic review (2025) · cites this paper as [13]
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Experimental — accuracy not yet measuredPlacental sequestration of infected red blood cells disrupts the exchange of nutrients and oxygen between mother and fetus, contributing to adverse pregnancy outcomes such as low birth weight, premature birth, and increased infant mortality.
“This sequestration in the placenta disrupts the exchange of nutrients and oxygen between mother and fetus, contributing to adverse pregnancy outcomes such as low birth weight, premature birth, and increased infant mortality [13].”
From Current update on malaria in pregnancy: a systematic review (2025) · cites this paper as [13]
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Experimental — accuracy not yet measuredPhysiological changes in the first pregnancy, which affect immune function and increase susceptibility to Plasmodium infection, make primigravidae particularly vulnerable to this disease and its complications.
“This suggests that the physiological changes in the first pregnancy, which affect immune function and increase susceptibility to Plasmodium infection, make primigravidae particularly vulnerable to this disease and its complications [13].”
From Current update on malaria in pregnancy: a systematic review (2025) · cites this paper as [13]
The Risk Factors for Malaria in Pregnancy section (page unavailable) says primigravidae are at greater risk of severe malaria in high-transmission areas and develop antibodies that offer partial protection in later pregnancies. It does not attribute their vulnerability to physiological changes in the first pregnancy that alter immune function, and it notes that the gravidity-related difference does not hold in low-transmission areas. (LLM, conf=0.85)
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References 70 · Cited by 167
Research works printed but not linked: 3
- [20]Marchesini PCJ. Reducing the burden of malaria in pregnancy. Geneva: World Health Organization; 2004: 2.
- [24]Cates JE, Unger HW, Briand V, Malaria, malnutrition, and birthweight: A meta-analysis using individual participant data. PLoS Medicine. 2017; 14: e1002373. 28792500 PMC5549702
- [65]Guidelines for the Treatment of Malaria, Third Edition. Geneva, Switzerland: World Health Organization; 2015.
- Authors
- Bauserman, M., Conroy, A. L., North, K., Patterson, J., Bose, C., & Meshnick, S.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- Indiana University School of Medicine (US)
- Corresponding author
- Bauserman, Melissa
- Venue
- Seminars in Perinatology
- Publisher
- Elsevier BV
- Published
- 2019-08
- Volume
- 43
- Issue
- 5
- Pages
- 282-290
- ISSN
- 0146-0005 (ISSN-L)
- PMC
- PMC7895297
- OpenAlex
- W2921699147
- Cited by
- 167
- References
- 70
- Citations by year
- 2026: 21 · 2025: 32 · 2024: 26 · 2023: 39 · 2022: 18 · 2021: 13 · 2020: 12 · 2019: 6
- FWCI
- 2.00
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Seminars in Perinatology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- IUScholarWorks (Indiana University) (submittedVersion)
- Purdue University Indianapolis (Indiana University) (submittedVersion)
- Funders
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (UG1HD076465)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Malaria Research and Control
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Keywords
- malaria in pregnancy, placental malaria, maternal morbidity, fetal outcomes, low birth weight, stillbirth, anemia, malaria diagnosis, malaria prevention, malaria treatment, Plasmodium falciparum
- MeSH terms
- Antimalarials, Female, Health Services Research, Humans, Infant, Newborn, Malaria, Pregnancy, Pregnancy Complications, Infectious, Pregnancy Outcome, Pregnancy Complications, Parasitic, HIV Infections, Malaria Vaccines, Infectious Disease Transmission, Vertical, Pregnant People, Coinfection
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