Malaria is a parasitic disease spread by mosquitoes. It affects millions of people worldwide and causes illness and mortality. Uncomplicated malaria has symptoms such as fever, headache, muscle pain, and vomiting, and children commonly present with rapid breathing or cough. Severe malaria causes unconsciousness and death. Women living in malarial areas and who are pregnant for the first or second time are more likely to become infected with malaria. This brings severe anaemia causing weakness and tiredness for the mother, and slows the growth of the baby. The review of trials assessed whether giving drugs on a regular basis to prevent malaria would have advantages in terms of health gains for the mother and baby, as this has to be balanced against drug adverse effects, and against risks of the malaria parasite developing resistance to these drugs. The review found seven trials looking at drugs given to all pregnant women where there was no benefit identified for either mother or baby. The review also found six trials involving 2495 pregnant women having their first or second babies. Drugs, like chloroquine, pyrimethamine, proguanil, and mefloquine, given routinely to women in their first or second pregnancy, reduced the number of women with severe anaemia in pregnancy. They were also associated with higher birthweight in the baby and probably fewer perinatal deaths. It was not possible to assess any potential impact on drug resistance.
Garner, P.; Gülmezoglu, A.M. Drugs for preventing malaria in pregnant women. Cochrane Database of Systematic Reviews (2006) (Issue 4) Art. No.: CD000169. [DOI: 10.1002/14651858.CD000169.pub2]