World Malaria Day is observed every year on April 25. The day highlights the global fight against malaria and the need for investment in its prevention, diagnosis, and treatment. Malaria is a life-threatening disease that is spread to humans by mosquitoes. It is caused by a parasite and does not spread from person to person. The World Health Organization (WHO) says that malaria is preventable and curable. WHO also states that globally, there were an estimated 282 million malaria cases and 6,10,000 malaria deaths in 2024. “The WHO African Region carries a disproportionately high share of the global malaria burden. In 2024, the WHO African Region was home to 95% of malaria cases (265 million) and 95% (5,79,000) of malaria deaths,” said WHO.
Malaria is a disease that can have severe outcomes if it is not treated immediately. It can cause complications like organ failure, anaemia, low blood sugar, and breathing problems, among others. The disease can be dangerous for pregnant women. Dr. Pankaj Puri, Principal Director, Internal Medicine at Fortis Escorts, Okhla, Delhi, said, “Malaria during pregnancy is a major cause of maternal morbidity worldwide and leads to poor birth outcomes. Pregnant patients are more prone to complications of malaria.”
Malaria Complications During Pregnancy
Malaria in pregnancy can seriously harm both the mother and the unborn baby, especially if the infection is not treated early. Here are some of the complications caused by malaria during pregnancy.
- Severe maternal anaemia: Malaria destroys red blood cells, so the pregnant woman tends to become very anaemic. This causes weakness, dizziness, and higher risk of complications during delivery.
- Low birth weight and poor growth: The parasite blocks blood flow in the placenta, reducing oxygen and nutrients to the baby, which can cause poor growth and low birth weight.
- Preterm birth and miscarriage: Fever and placental damage can trigger early labour or miscarriage, especially in the first and second trimester.
- Stillbirth and neonatal death: In severe cases, the baby may die in the womb or shortly after birth because of poor placental function and infection.
- Congenital malaria: Rarely, the baby can be born with malaria if the parasite passes from mother to child, causing fever and anaemia after birth.
- Severe illness in the mother: Pregnant women are more likely to develop severe malaria with complications such as very high fever, breathing problems, kidney issues, or even death.
Preventing Malaria In Pregnant Women
The major tools for preventing malaria in pregnant patients are mosquito avoidance and preventive drug therapy.
Avoiding mosquitoes is a key intervention for reducing malaria acquisition, said Dr. Puri. Mosquitoes capable of transmitting malaria infection (Anopheles species) usually feed at night. Hence, pregnant patients are advised to lower exposure to these insects between dusk and dawn by staying in screened areas whenever possible, using mosquito netting (ideally treated with permethrin or other pyrethroid), covering exposed skin with clothing, and applying insect repellent.
Treating Malaria In Pregnant Women
Intermittent Preventive Treatment in Pregnancy
Residents of endemic areas and patients without human immunodeficiency virus (HIV) infection are given Intermittent Preventive Treatment in Pregnancy (IPTp). IPTp refers to the strategy of administering antimalarial medication at intervals during pregnancy regardless of clinical symptomatology. Benefits include fewer deliveries of low birth weight infants and less maternal anaemia.
Malaria in pregnancy can have severe consequences for both the mother and the fetus; therefore, pregnant patients with malaria should be treated promptly with an effective antimalarial agent to rapidly clear parasitemia. Safety and efficacy data to guide treatment are limited . In general, newer drugs are more likely to be effective than older drug.
Artemether-lumefantrine
Treatment regimens for pregnant patients with uncomplicated Chloroquine-resistant P. falciparum malaria are treated with a three day course of artemether-lumefantrine combination. Those with Chloroquine sensitive malaria can be treated but chloroquine or quinine
Pregnant women are more likely to develop severe P. falciparum malaria than other adults, particularly in the second and third trimesters. Complications such as hypoglycemia and pulmonary edema are more common than in nonpregnant individuals. Maternal mortality can approach 50%, and foetal death and premature labour are common.
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