Malaria in Pregnancy: Risks, Symptoms, Treatment and Prevention 

By: Temitayo Adeola, RN, RM, RPHN Freelance health writer and DLHA Volunteer. Medically reviewed by: E. Odekina, MBBS. Family Physician.

September 14, 2026

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Pregnant African women sit together in an antenatal clinic while waiting for care. Image credit: ChatGPT. Click on image to enlarge. 

 

Highlights 

• Malaria during pregnancy can affect both the mother and developing baby.

• Pregnancy can make women more vulnerable to malaria, particularly Plasmodium falciparum infection.

• Malaria in pregnancy is associated with complications such as anaemia, preterm birth, stillbirth and low birth weight.

• Prevention, early testing and appropriate treatment can help protect mothers and babies.

 

Introduction 

Preparing for a new baby is a time filled with hope, anticipation and careful planning. Across sub-Saharan Africa, millions of women await the arrival of their little ones each year. Yet pregnancy can also bring added health concerns, malaria among others.

A bite from an infected mosquito can have serious consequences during pregnancy. 

The burden of malaria remains particularly high in the region. In 2024, the WHO African Region accounted for about 94% of malaria cases and 95% of malaria deaths worldwide. Nigeria was responsible for about 31.9% of malaria deaths in the African Region, highlighting the importance of malaria prevention and care during pregnancy [1].

Pregnancy itself can make a woman more vulnerable to malaria, while Plasmodium falciparum parasites can accumulate in the placenta, creating additional risks for both mother and baby.

This article explores why malaria raises pregnancy risks, how it can affect maternal and fetal health, and the treatment and preventive measures that can help protect both mother and baby.

 

What is Malaria?

Malaria is a mosquito-borne infectious disease caused by Plasmodium parasites. It occurs when a person is bitten by an infected female Anopheles mosquito, allowing the parasite to enter the bloodstream. The parasite then develops in the body and infects red blood cells, causing symptoms such as fever, chills, headache, and weakness. Although malaria is preventable and treatable, delayed diagnosis or treatment can become severe and may even be life threatening [1, 2].

 

Why Malaria Raises Pregnancy Risks 

A simple medical infographic showing how pregnancy increases the risk of malaria and how the infection affects the placenta. Credit: Perplexity. Click on image to enlarge.

 

Pregnancy and Increased Malaria Risks 

Pregnancy changes how the body immune system responds to infections, which can make a woman more vulnerable to malaria. At the same time, the placenta creates an environment that allows certain malaria parasites to behave differently during pregnancy. These factors make malaria in pregnancy a particular concern in areas where the disease is common [3, 4].

This is especially important with Plasmodium falciparum, the parasite responsible for most malaria cases in Africa. During pregnancy, infected red blood cells can attach to the placenta and accumulate there. This is known as placental malaria. The build-up of infected cells can cause inflammation in the placenta and interfere with its normal function [4].

The likelihood of placental malaria can also vary with pregnancy history. Women experiencing their first pregnancy may be more vulnerable because their immune system may not yet have developed the specific protection needed to prevent malaria-infected cells from attaching to the placenta [5].

With previous pregnancies in malaria-endemic areas, women may develop greater immunity to these pregnancy-specific forms of the parasite [5].

These biological changes help explain why malaria can pose a greater threat during pregnancy than at other times in a woman’s life.

 

How Malaria Affects the Mother and Baby

An infographic highlighting the possible effects of malaria on pregnancy outcomes. Image credit: Grok. Click on image to enlarge.

 

Malaria during pregnancy affects both the mother and her developing baby. The infection can place the mother at risk of serious illness while also increasing the risk of complications for the pregnancy and baby. Understanding these effects highlights why early testing and appropriate treatment are so important. 

Effects on the Mother

• Anaemia: Malaria can destroy red blood cells, which may reduce the amount of haemoglobin available to carry oxygen around the body. A woman with anaemia (low red blood cell levels) may experience tiredness, weakness, dizziness or shortness of breath. In severe cases, anaemia can increase the risk of serious illness and death [4].

• Severe malaria: Malaria can become severe, particularly when diagnosis and treatment are delayed. Severe malaria can affect the brain, kidneys, lungs and other vital organs. It may cause problems such as confusion, seizures, difficulty breathing or loss of consciousness and can be life-threatening [2].

•  Increased risk of complications during pregnancy: Malaria can place additional stress on the mother's body during pregnancy. In malaria-endemic areas of sub-Saharan Africa, Plasmodium falciparum is responsible for most of the malaria-related complications seen in pregnancy, such as low blood sugar, sudden fluid build-up in the lungs, and malaria affecting the brain. The infection can contribute to maternal anaemia and severe disease, making timely diagnosis and treatment especially important [3, 6].

• Maternal death: In its most severe form, malaria can be fatal. The risk is particularly concerning when severe disease develops or treatment is delayed. This is one reason malaria in pregnancy should not be dismissed as an ordinary fever or managed poorly [7].

Effects on the baby

• Placental malaria: When malaria parasites accumulate in the placenta, they can affect the environment in which the baby develops. Placental malaria is particularly important in malaria-endemic areas of sub-Saharan Africa and has been linked to adverse outcomes for the baby [8].

• Miscarriage and stillbirth: Malaria during pregnancy can adversely affect the fetus and is associated with an increased risk of pregnancy loss, including miscarriage and stillbirth. The risk is particularly concerning in malaria-endemic areas, where pregnant women may be exposed to repeated infections [9].

• Preterm birth: Malaria during pregnancy can increase the risk of preterm birth- when a baby is born before 37 completed weeks of pregnancy. Babies born too early may have difficulties with breathing, feeding and maintaining body temperature and may need specialised care after birth [9].

• Low birth weight: Babies exposed to malaria during pregnancy have a higher risk of being born with low birth weight. Low birth weight can make newborns more vulnerable to infections and other health problems [9].

 

Treatment of Malaria during Pregnancy

A flowchart outlining the diagnosis and treatment of malaria during pregnancy, based on trimester and severity. Image credit: Grok. Click on image to enlarge.

 

WHO recommends that all suspected cases of malaria be confirmed using parasite-based diagnostic testing (through either microscopy or a rapid diagnostic test).

The appropriate treatment depends on factors such as the malaria parasite involved, the severity of the infection, local drug resistance patterns and the stage of pregnancy. 

For uncomplicated P. falciparum malaria, WHO currently recommends artemether–lumefantrine, an artemisinin-based combination therapy (ACT), during the first trimester. ACTs are also recommended during the second and third trimesters [2, 10].

If malaria becomes severe, urgent hospital treatment is required. WHO recommends intravenous artesunate for severe malaria, including during pregnancy [2, 10].

 

Preventing Malaria during Pregnancy

An educational illustration promoting malaria prevention and healthy pregnancy practices. Image credit: Gemini. Click on image to enlarge.

 

Here are ways to ways you can prevent malaria attack during pregnancy:

• Take Intermittent Preventive Treatment in pregnancy (IPTp?SP): In areas of moderate to high malaria transmission in Africa, WHO recommends that all pregnant women receive sulfadoxine pyrimethamine (SP) as preventive treatment, with each dose administered monthly on ANC visits starting in the early stage of the second trimester until the time of delivery [10].

• Use Insecticide?treated nets (ITNs/LLINs): Pregnant women should sleep every night under a long?lasting insecticide?treated net (LLIN), ideally from the first antenatal visit. This helps reduce mosquito bites, lower the chance of infection, and protect the baby indirectly by preventing placental malaria [10].

• Attend antenatal care: Regular antenatal care provides opportunities for pregnant women to receive recommended malaria prevention, testing and treatment as well as other essential pregnancy care. 

• Seek care promptly when symptoms develop: Fever, chills, headache or other symptoms that could indicate malaria should not be ignored during pregnancy. Prompt testing and treatment can help prevent the infection from becoming severe.

 

When to Seek Professional Help

Malaria can become severe and life-threatening if treatment is delayed. Pregnant women are at higher risk of severe malaria, so symptoms should not be ignored.

Seek urgent medical attention if you experience:

• Fever
• Severe Headache 
• Generalized body pain 
• Extreme tiredness or severe weakness
• Repeated vomiting 
• Difficulty breathing
• Confusion or reduced alertness
• Seizures or convulsions
• Loss of consciousness
• Yellowing of the eyes or skin (jaundice)
• Dark or bloody urine
• Abnormal bleeding

 

Conclusion 

Malaria remains an important health concern during pregnancy, particularly in sub-Saharan Africa. However, prevention, early testing and appropriate treatment can reduce the risk of serious complications.

If you are pregnant and develop symptoms that could indicate malaria, seek professional care promptly and do not self-medicate. Early care can help protect both you and your baby.

 

Frequently Asked Questions (FAQ)

• Can malaria affect my baby during pregnancy?

Yes. Malaria during pregnancy can affect both the mother and baby. It is associated with an increased risk of pregnancy loss, including miscarriage and stillbirth, as well as premature delivery and low birth weight.

• Is malaria treatment safe during pregnancy?

Yes. Malaria can be treated during pregnancy, and seeking treatment early is important to protect both mother and baby. However, not every antimalarial medicine is suitable for every pregnant woman.

Do not self-medicate if you suspect malaria. Speak with a qualified healthcare professional for proper assessment and treatment.

• How can I prevent malaria while pregnant?

You can reduce your risk by sleeping under an insecticide-treated net every night, attending antenatal care and taking recommended preventive treatment where it is offered. In malaria-endemic areas of Africa, WHO recommends intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) for pregnant women, beginning in the second trimester and with doses given at least one month apart.

 

References: 

1. World Health Organization (WHO). Malaria [Internet]. 4 December 2025. [Cited 2026 Sep 5]. Available from here.

2. Samandari T, Gillespie E. Severe Malaria. [Updated 2026 May 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. [Cited 2026 Sep 5]. Available from here.

3. Minwuyelet A, Yewhalaw D, Siferih M, Atenafu G. Current update on malaria in pregnancy: a systematic review. Tropical Diseases Travel Medicine and Vaccines. 2025 May 21;11(1):14. Available from here.
 

4. Rogerson SJ, Mwapasa V, Meshnick SR. Malaria in Pregnancy: Linking Immunity and Pathogenesis to Prevention. In: Breman JG, Alilio MS, White NJ, editors. Defining and Defeating the Intolerable Burden of Malaria III: Progress and Perspectives: Supplement to Volume 77(6) of American Journal of Tropical Medicine and Hygiene. Northbrook (IL): American Society of Tropical Medicine and Hygiene; 2007 Dec. Available from here.

5. Berhe AD, Doritchamou JYA, Duffy PE. Malaria in pregnancy: adverse pregnancy outcomes and the future of prevention. Frontiers in Tropical Diseases [Internet]. 2023 Aug 14;4.1229735, Available from here.

6. World Health Organization. World malaria report 2024 [Internet]. 2024 Dec. 11. [Cited 2026 Sep 5]. Available from here.

7. World Health Organization: WHO. Maternal health [Internet]. 2019 [Cited 2026 Sep 5]. Available from here.

8. Chua CLL, Hasang W, Rogerson SJ, Teo A. Poor Birth Outcomes in Malaria in Pregnancy: Recent Insights into Mechanisms and Prevention Approaches. Frontiers in Immunology [Internet]. 2021 Mar 15;12:621382. Doi: org/10.3389/fimmu.2021.621382. Available from here.

9. Menon S, D’Alessio F, Chaudhuri N, Onwuchekwa C, Kaur M, Nkumama I, et al. Placental malaria: a systematic review and meta-analysis of global burden, risk factors, and maternal and foetal outcomes. Journal of Global Health. 2025 Nov 27;15:04355. Available from here.

10. Rogerson SJ. Management of malaria in pregnancy. The Indian Journal of Medical Research [Internet]. 2017 Sep 1;146(3):328–33. Available from here.  

 

 

Related:

Routine Tests in Pregnancy: A Practical Guide for African Women

Maternal Mortality in sub-Saharan Africa: A Call to Action

What Africans Need to Know About Antenatal Care

5 Ways Early Prenatal Care Protects You and Your Baby 

 

 

Published: September 14, 2026

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