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Rogerson, Stephen J. and Unger, Holger (2022) 'Pregnancy and malaria: the perfect storm'. Current Opinion in Infectious Diseases, Vol 35, Issue 5, pp. 410-416.
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Abstract
Purpose of review
Malaria in pregnancy continues to exert a toll on pregnant women and their offspring.
Recent findings
The burden of Plasmodium falciparum infection is especially large in Africa, and new data show lasting effects of maternal infection on the infant's neurocognitive development. Elsewhere, P. vivax infection causes relapsing infections that are challenging to prevent. Infection in first trimester of pregnancy is an area of increasing focus, and its adverse effects on pregnancy outcome are increasingly recognised. First-trimester infection is common and frequently acquired prior to conception. Although newer rapid diagnostic tests still have limited sensitivity, they may be useful in detection of early pregnancy malaria for treatment. Artemisinin-based combination therapies are efficacious in later pregnancy but have yet to be recommended in first trimester because of limited safety data. In Africa, intermittent preventive treatment in pregnancy (IPTp) with monthly sulfadoxine-pyrimethamine improves pregnancy outcomes, but sulfadoxine-pyrimethamine resistance is worsening. The alternative, IPTp with dihydroartemisinin-piperaquine, has greater antimalarial efficacy, but does not appear to improve pregnancy outcomes, because sulfadoxine-pyrimethamine has poorly understood nonmalarial benefits on birthweight.
Summary
Novel IPTp regimens must be combined with interventions to strengthen protection from malaria infection acquired before and in early pregnancy.
| Item Type: | Article |
|---|---|
| Subjects: | WC Communicable Diseases > Tropical and Parasitic Diseases > WC 750 Malaria WQ Obstetrics > Pregnancy > WQ 200 General works |
| Faculty: Department: | Clinical Sciences & International Health > Clinical Sciences Department |
| Digital Object Identifer (DOI): | https://doi.org/10.1097/qco.0000000000000859 |
| SWORD Depositor: | JISC Pubrouter |
| Depositing User: | JISC Pubrouter |
| Date Deposited: | 06 Oct 2023 14:08 |
| Last Modified: | 06 Oct 2023 14:08 |
| URI: | https://archive.lstmed.ac.uk/id/eprint/23262 |
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