Malaria affects millions of pregnant women each year. African women bear the brunt of this disease during their first pregnancy and are likely to lose the semi-immunity normally found in adults.

“There is the tendency for people to see malaria as ordinary, but it is a serious disease. The mother and the baby could be seriously affected if it is not properly and promptly treated. The risk to the mother includes low blood level (anaemia) in pregnancy, which could become severe and necessitate blood transfusion,” Dr. Kayode Afolabi, a Consultant Obstetrician and Gynaecologist at the University College Hospital, Ibadan, in Nigeria's Oyo State, has said.
“In the case of the unborn baby, malaria could lead to miscarriage, referred to in the medical parlance as spontaneous abortion, depending on the stage at which the malaria occurs,” Dr Afolabi added.
“The baby may be born premature, with a low birth weight due to retarded growth while in the womb. This is why the use of malaria medications is always considered an important issue and emphasis is placed on its prevention. Currently, we are embarking on the prevention of malaria in pregnancy with two to three doses of the prescribed antimalarial drug (sufadoxine-pyreimethamine) during pregnancy. This starts after the first three months of pregnancy when it is certain that the medication would not cause any deformity in the developing child in the womb,” he said.
Research shows that pregnant women attract twice the number of mosquitoes as non-pregnant women, which probably increases their risk of contracting malaria.
In these young mothers, the Plasmodium falciparum (a parasite that causes malaria) accumulates in the placenta, causing them to become short on blood. The children of infected mothers often are underdeveloped or babies with lower birth weights. Sometimes, children of such mothers with severe malaria are delivered as premature babies or die while still in the womb.
But that is not all about the effects of malaria during pregnancy. One of the consequences of malaria has been shown in new research to include pre-eclampsia (very high blood pressure and protein loss in the urine), which carries high risks for both mother and child for women in their first pregnancy.
Pre-eclampsia is thought to be more common in some parts of the world where there is severe malaria problem and it has often been speculated that there might be a connection. Malaria is more common in a first pregnancy and so is pre-eclampsia.
Dr. Afolabi described pre-eclampsia as a condition in pregnancy where the woman has high blood pressure coexisting with protein in urine. What is obvious to the human eyes is that they appear blown up.
“Looking at them, their whole body is swollen, especially their face, hands and feet,” he declared.
He said so many things could predispose a woman to pre-eclampsia.
“It is a disease that is common in women who are getting pregnant for the first time or those that are getting pregnant for a new husband, even though they have had previous pregnancies or deliveries in the past.”
In addition, he said that “it is common among women who before pregnancy have had other medical problem like diabetes, hypertension or even kidney problems. Women who have multiple pregnancies are equally prone to developing the problem.”
Dr. Afolabi described malaria and pre-eclampsia as two common problems of pregnant women, stressing that there is a possibility of malaria contributing to cases of pre-eclampsia in women.
He also touched on another effects of malaria in pregnancy. This is where a pregnant woman who has malaria could have a high concentration of malaria parasites developing in the placenta. The placenta is the cord attaching the unborn baby to the mother and this cord supplies it with oxygen and nutrients from the mother.

When a pregnant woman has a high concentration of malaria parasites developing in the placenta, she is said to have ‘placental malaria’. This is very harmful to the mother and to the unborn baby; it leads to low birth weight and, in Africa alone, is estimated to be responsible for the deaths of about 200,000 infants every year. A woman who is pregnant for the first time is most likely to suffer from placental malaria, and to have her placenta become highly infected and extremely inflamed.
Dr. Afolabi explained that in a situation where a woman has a high load of malaria parasites in the placenta, the effectiveness of the placenta in carrying oxygen and nutrient supplies to the baby would be affected.
“Due to the high load of malaria parasite in the placenta, there could be damage to the placenta in such a way that it could predispose the mother to pre-eclampsia,” he said.
Pre-eclampsia itself is a serious complication of pregnancy and affects one out of every 10 pregnant women in Nigeria according to Dr. Bukola Fawole, a Consultant obstetrician and Gynaecologist at the University College Hospital (UCH) Ibadan. The condition is often silent and shows up unexpectedly during a routine blood pressure check and urine test, but according to Dr. Fawole it cannot be out rightly said to be due to malaria.
“Right now, we do not know if there is a direct connection between malaria parasites within the placenta leading to pre-eclampsia.,” Dr Fawole says.
”What we know is that when there are malaria parasites in the placenta, it has its own problems. It leads to reduced growth of the baby and in very severe situations the baby may end up dying right in the womb.” says Dr. Fawole.
Researchers from the USA, UK and Tanzania investigating the possibility that malaria might lead to pre-eclampsia found out that first-time young mothers, having placental malaria increased the risk of hypertension about three-fold.
Pregnant women with pre-eclampsia are usually advised to take time off work, have bed rest, take medication, and sometimes even hospitalised to keep the blood pressure under control. Unfortunately, the only “cure” for the disease is delivery of the baby, but it is in the best interest of the babies to be kept in the womb as long as possible. Sometimes it is in the best interest of the mother to deliver the baby before term.