Poor Birth Outcomes in Malaria in Pregnancy: Recent Insights Into Mechanisms and Prevention Approaches

Abstract

Pregnant women in malaria-endemic regions are susceptible to malaria in pregnancy, which has adverse consequences on birth outcomes, including having small for gestational age and preterm babies. These babies are likely to have low birthweights, which predisposes to infant mortality and lifelong morbidities. During malaria in pregnancy, Plasmodium falciparum-infected erythrocytes express a unique variant surface antigen, VAR2CSA, that mediates sequestration in the placenta. This process may initiate a range of host responses that contribute to placental inflammation and dysregulated placental development, which affects placental vasculogenesis, angiogenesis and nutrient transport. Collectively, these result in the impairment of placental functions, affecting fetal development. In this review, we provide an overview of malaria in pregnancy and the different pathological pathways leading to malaria in pregnancy-associated low birthweight. We also discuss current prevention and management strategies for malaria in pregnancy, and some potential therapeutic interventions that may improve birth outcomes. Lastly, we outline some priorities for future research that could bring us one step closer to reducing this health burden.

Ramadan Fasting during Pregnancy and Health Outcomes in Offspring: A Systematic Review

“…These prospective studies should be carefully designed, as the sociological and religious dimension of Ramadan may also alter maternal behavior to protect the belief that Ramadan has no effect on their offspring. Another promising approach to studying these effects would be enhanced retrospective study designs based on routine data collection comparing Islamic pregnant women during and outside the Ramadan period to reduce the effect of confounding but only under the condition that (Ramadan) fasting is registered in routine care, as other seasonal effects on birth outcomes may still apply such as malaria [ 73 , 74 ] and vitamin D status [ 75 , 76 ]. These types of studies are also needed in order to confirm the results of high quality studies in birth and fetal health outcomes.…”

Predictors of knowledge and use of long-lasting insecticidal nets for the prevention of malaria among the pregnant women in Pakistan

“…This finding is supported by a longitudinal survey that showed that the newborns are at high risk of death and observed a significant reduction in mean birth weight in babies of women with malaria during pregnancy. Malaria during pregnancy was a predictor of knowledge and use of LLINs, and it is a known risk of adverse pregnancy outcomes like miscarriage, preterm birth, stillbirth, and low birth weight leading to high infant mortality [ 5 , 35 ]. The finding of previous malaria infection strongly underscores the need for preventive efforts during malaria.…”

Low Abundance Fusobacterium Nucleatum Supports Early Pregnancy Development – An In Vitro Study

“…First trimester infections are associated to placenta development problems ( 94 – 97 ). In the context of malaria, Plasmodium -infection affects the placental vascular development, as seen by a reduced transport capacity, syncytiotrophoblast knotting, thickening of the basal membrane, decreased trophoblast invasion and inflammatory disorders (disruption of the cytokine milieu and immune cell recruiting) ( 98 ). Our data suggests that uncontrolled infections with F. nucleatum in early pregnancy might impact placental development as well.…”