Experts Warn of Severe Pregnancy Risks Linked to Poorly Treated Malaria

Disease can damage placenta, restrict foetal growth, trigger premature birth and stillbirth, specialists say. Medical experts have warned that malaria infection during pregnancy can pose serious risks to both mothers and unborn babies, stressing that delayed diagnosis and inadequate treatment can lead to life-threatening complications. According to maternal health specialists, poorly managed malaria can cause inflammation of the placenta, disrupt the supply of oxygen and nutrients to the developing baby, and increase the likelihood of foetal growth restriction, premature delivery and stillbirth. They explained that pregnancy naturally reduces a woman’s immunity, making expectant mothers more vulnerable to malaria infection and increasing the risk of severe complications. The experts emphasised that early detection, appropriate treatment and preventive medication remain essential measures in protecting the health of pregnant women and their babies. The World Health Organisation (WHO) has identified malaria infection during pregnancy as a major public health challenge, particularly in areas with moderate and high malaria transmission, due to its impact on mothers, unborn children and newborns. WHO estimates show that in 2018, about 11 million pregnant women were infected with malaria in sub-Saharan Africa, contributing to nearly 900,000 cases of babies being born with low birth weight. Nigeria remains one of the countries with the highest malaria burden globally. According to the United Nations Children’s Fund (UNICEF), the country accounts for about 27 per cent of global malaria cases and 31 per cent of malaria-related deaths. The 2023 World Malaria Report recorded approximately 200,000 malaria deaths, with children under five years and pregnant women among the groups most affected. Data from the Federal Ministry of Health indicates that malaria contributes to about 11 per cent of maternal deaths and 70.5 per cent of morbidity cases during pregnancy in Nigeria. Speaking to PUNCH Healthwise on the dangers of malaria in pregnancy, Professor of Obstetrics and Gynaecology at the University of Uyo, Akwa Ibom State, Aniekan Abasiattai, said the disease can negatively affect both the expectant mother and the developing foetus when not properly diagnosed and treated. He explained that pregnancy weakens a woman’s natural defence against malaria, increasing the possibility of infection and making complications more likely. Abasiattai said: “Malaria has effects on both the mother and the baby during pregnancy. To avoid these deleterious effects, malaria must be diagnosed early and treated properly.” He added: “If malaria is not properly diagnosed and treated, both the mother and the baby stand the risk of developing the adverse effects of malaria during pregnancy.” The professor explained that pregnant women may lose some of the immunity they had previously developed against malaria, leaving them more susceptible to infection compared with women who are not pregnant. According to him, malaria parasites can accumulate in the placenta even when they are not easily detected in a mother’s bloodstream, interfering with the exchange of oxygen and essential nutrients required for healthy foetal development. “In malaria-endemic environments like ours, the malaria parasites may not even be visible in the peripheral blood, but they can sequester in the placenta and reduce the exchange of nutrients and oxygen to the foetus. As a result, the baby’s growth is restricted. It can even lead to the death of the foetus,” Abasiattai said. He noted that placental malaria can result in serious pregnancy outcomes, including restricted foetal growth, intrauterine foetal death, premature labour and preterm delivery. The university don further explained that malaria is a major cause of anaemia during pregnancy because the parasite destroys red blood cells, reducing the amount of oxygen available to both the mother and baby. He said: “Malaria is also one of the most common causes of anaemia during pregnancy. As you know, what the malaria parasites do is destroy red blood cells. They cause haemolysis—not only of the red blood cells containing the parasites but also, through other mechanisms, of red blood cells that are not infected. Over time, this leads to anaemia.” According to him, reduced oxygen supply caused by anaemia can contribute to low birth weight, impaired growth and, in severe cases, foetal death. Abasiattai also noted that although uncommon, babies can contract malaria before birth through congenital malaria, where parasites cross the placenta from the mother to the unborn child. He explained that while mothers transfer protective antibodies to their babies during pregnancy, malaria infection can still occur, making early medical attention necessary when newborns develop symptoms such as fever. Also speaking, Consultant Obstetrician and Gynaecologist at the Federal Medical Centre, Abeokuta, Ogun State, Dr Olanrewaju Jimoh, warned that malaria in pregnancy should not be treated as an ordinary illness. He said the disease can affect both mother and child in multiple ways when left untreated or poorly managed. “When a pregnant woman develops malaria, the malaria parasites—particularly Plasmodium falciparum—accumulate within the placenta. Once the parasites invade the placenta, they trigger what we call inflammation of the placenta,” Jimoh said. The consultant explained that inflammation of the placenta affects its ability to support the unborn baby, potentially leading to poor growth and other complications. He added that in some cases, malaria parasites can cross the placental barrier and infect babies before birth, resulting in congenital malaria. According to him, affected newborns may experience complications such as jaundice, difficulty controlling blood sugar levels, breathing problems and severe infections. He said: “Although congenital malaria is not very common, when it occurs, it can present with temperature abnormalities, difficulty controlling blood sugar levels, jaundice, and respiratory distress. The baby may not be able to breathe well and may require oxygen and other intensive care measures.” Jimoh added: “Sometimes, because of overwhelming sepsis and these other complications, some babies may still die and not survive. Those are the major issues.” He noted that some studies have linked congenital malaria with possible developmental challenges among affected children, although more research and long-term monitoring are still needed. Beyond its impact on babies, Jimoh warned that malaria can also have severe consequences for pregnant women because of pregnancy-related changes in immunity. He said expectant mothers are at increased risk of complications including severe anaemia, cerebral malaria, low blood sugar, breathing difficulties, kidney problems, miscarriage and, in extreme cases, death. The consultant stressed that many of these complications can be prevented through regular antenatal care and the use of Intermittent Preventive Treatment in pregnancy. He advised pregnant women to receive sulfadoxine-pyrimethamine during antenatal visits as recommended, noting that the preventive medication reduces the risk of malaria infection and its associated complications. Jimoh said the WHO recommends that pregnant women receive at least three doses of the preventive treatment during pregnancy, with additional doses provided where necessary. He added that the intervention has proven effective in reducing placental malaria, congenital malaria and other negative pregnancy outcomes associated with the disease.

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