title: Pregnancy-associated malaria and malaria in infants: an old problem with present consequences.
abstract: Albeit pregnancy-associated malaria (PAM) poses a potential risk for over 125 million women each year, an accurate review assessing the impact on malaria in infants has yet to be conducted. In addition to an effect on low birth weight (LBW) and prematurity, PAM determines foetal exposure to Plasmodium falciparum in utero and is correlated to congenital malaria and early development of clinical episodes during infancy. This interaction plausibly results from an ongoing immune tolerance process to antigens in utero, however, a complete explanation of this immune process remains a question for further research, as does the precise role of protective maternal antibodies. Preventive interventions against PAM modify foetal exposure to P. falciparum in utero, and have thus an effect on perinatal malaria outcomes. Effective intermittent preventive treatment in pregnancy (IPTp) diminishes placental malaria (PM) and its subsequent malaria-associated morbidity. However, emerging resistance to sulphadoxine-pyrimethamine (SP) is currently hindering the efficacy of IPTp regimes and the efficacy of alternative strategies, such as intermittent screening and treatment (IST), has not been accurately evaluated in different transmission settings. Due to the increased risk of clinical malaria for offspring of malaria infected mothers, PAM preventive interventions should ideally start during the preconceptual period. Innovative research examining the effect of PAM on the neurocognitive development of the infant, as well as examining the potential influence of HLA-G polymorphisms on malaria symptoms, is urged to contribute to a better understanding of PAM and infant health.
authors.affiliation: Institut de Recherche pour le Développement, UMR 216 Mère et enfant face aux infections tropicales, Faculté de Pharmacie Paris Descartes, 4 Avenue de l'Observatoire, 75270 Paris, France. vmoyaalvarez@gmail.com.
authors.forename: Violeta
authors.initials: V
authors.lastname: Moya-Alvarez
authors.forename: Rosa
authors.initials: R
authors.lastname: Abellana
authors.forename: Michel
authors.initials: M
authors.lastname: Cot
mesh_terms: D000328:Adult; D017954:Africa South of the Sahara / Q000453:epidemiology; D000962:Antimalarials / Q000008:administration & dosage / Q000627:therapeutic use; D015897:Comorbidity; D003167:Complement Activation; D002658:Developmental Disabilities / Q000209:etiology / Q000276:immunology; D004338:Drug Combinations; D004351:Drug Resistance; D005260:Female; D005315:Fetal Diseases / Q000469:parasitology / Q000517:prevention & control; D005317:Fetal Growth Retardation / Q000209:etiology; D020022:Genetic Predisposition to Disease; D015658:HIV Infections / Q000453:epidemiology; D059951:HLA-G Antigens / Q000235:genetics / Q000276:immunology; D006801:Humans; D007108:Immune Tolerance; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000453:epidemiology / Q000469:parasitology; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control; D008288:Malaria / Q000151:congenital / Q000188:drug therapy / Q000196:embryology / Q000453:epidemiology* / Q000276:immunology / Q000517:prevention & control / Q000635:transmission; D016779:Malaria, Cerebral / Q000150:complications / Q000196:embryology / Q000276:immunology; D018512:Parasitemia / Q000151:congenital / Q000453:epidemiology / Q000635:transmission; D010963:Plasmodium falciparum / Q000187:drug effects / Q000235:genetics; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy / Q000453:epidemiology* / Q000276:immunology / Q000469:parasitology; D011739:Pyrimethamine / Q000494:pharmacology / Q000627:therapeutic use; D012307:Risk Factors; D050497:Stillbirth / Q000453:epidemiology; D013413:Sulfadoxine / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D000962:Antimalarials; D004338:Drug Combinations; D059951:HLA-G Antigens; C001205:fanasil, pyrimethamine drug combination; D013413:Sulfadoxine; D011739:Pyrimethamine