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. 17 trials were included, all conducted
between 1957 and 2008, and all but 2 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
This research is supported by the Department for International Development’s Evidence Building and Synthesis Research Programme which is led by Liverpool School of Tropical Medicine
Radeva-Petrova, D.; Kayentao, K.; ter Kuile, F.O.; Sinclair, D.; Garner, P. 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. [DOI: 10.1002/14651858.CD000169.pub3]
Drugs for preventing malaria in pregnant women in endemic areas: any drug regimen versus placebo or no treatment