Malaria in Pregnancy: What the Obstetric Provider in Nonendemic Areas Needs to Know

IMPORTANCE: Globally, over 125 million women each year are at risk of malaria during pregnancy. Endemic regions carry the greatest burden; however, with globalization, providers in non-endemic regions are encountering increasing numbers of women with exposed to or infected with malaria. OBJECTIVES: The aim of this paper is to provide obstetric providers in non-endemic areas with updated information on malaria infection in pregnancy focusing on pregnancy management, and malaria prevention and treatment. EVIDENCE ACQUISITION: This paper is based on review of the most recent peer-reviewed articles and guidelines from the Centers for Disease Control and the World Health Organization. FINDINGS: Malaria infection in pregnancy causes maternal anemia, low-birthweight, preterm birth, stillbirth and miscarriages through placental malaria and severe infections. Pregnant women traveling to malaria-endemic areas should be advised against travel. If travel must occur, they should be provided with region-specific chemoprophylaxis and given methods for preventing infection. In the event that a pregnant patient has an acute malarial infection, prompt evaluation is needed to determine whether there are severe features. Medications for uncomplicated or severe malaria infection should be started as soon as the diagnosis is made. CONCLUSIONS AND RELEVANCE: Malaria in pregnancy causes significant perinatal complications. Obstetric providers should be aware of the impact and how to prevent and treat malaria infection during pregnancy. Malaria infection should be suspected in women with concerning symptoms and recent travel to endemic areas. Providers should know the management of uncomplicated and severe malarial infection in pregnancy.