Drugs for preventing malaria in pregnant women in endemic areas: any drug regimen versus placebo or no treatment

The effect of taking antimalarial drugs routinely to prevent malaria in pregnancy

Denitsa Radeva-Petrova1, Kassoum Kayentao1,2, Feiko O ter Kuile1, David Sinclair3, Paul Garner3

1 Liverpool School of Tropical Medicine, Child & Reproductive Health Group, Liverpool, UK
2 University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali
Liverpool School of Tropical Medicine, Department of Clinical Sciences, Liverpool, UK

Drugs for preventing malaria in pregnant women in endemic areas: any drug regimen versus placebo or no treatment. Cochrane Database of Systematic Reviews 2014, Issue 10. Art. No.: CD000169.

To read the full review please follow this link: DOI:10.1002/14651858.CD000169.pub3.

Pregnancy increases the risk of malaria and this is associated with poor health outcomes for both the mother and the infant, especially during the first or second pregnancy. For this reason, women are encouraged to try and prevent malaria infection during pregnancy by sleeping under mosquito bed-nets, and by taking drugs effective against malaria throughout pregnancy as chemoprevention.

This Cochrane Review looked at all drug regimens compared to placebo. The review authors sought to summarise and quantify the overall effects of chemoprevention. Seventeen trials were included, all conducted between 1957 and 2008, and all but two in countries of Africa.

For women in their first or second pregnancy, malaria chemoprevention prevents moderate to severe anaemia (high quality evidence); and prevents malaria parasites being detected in the blood (high quality evidence). It may also prevent malaria illness. We don't know if it prevents maternal deaths, as this would require very large studies to detect an effect.

In their infants, malaria chemoprevention improves the average birthweight (moderate quality evidence), and reduces the number of low birthweight infants (moderate quality evidence). We are not sure if chemoprevention reduces mortality of babies in the first week, month and year, as again studies would need to be very large to show these effects.