Explained: Malaria Infection And The Fetal Risks It Can Cause During Pregnancy
Malaria is a disease that is transmitted through an infected mosquito that carries the Plasmodium parasite. When this infected mosquito bites a pregnant woman, the parasite travels to the liver where it matures. After several days, the mature parasites enter the bloodstream and infect the red blood cells which multiply causing the infected cells to burst open.
What causes malaria?
Malaria occurs due to a bite of a mosquito infected with the Plasmodium parasite. There are four kinds of malaria parasites that infect humans namely Plasmodium vivax, P. ovale, P. malariae, and P. falciparum. Amongst these, P. falciparum is more severe and those who contract this form of malaria have a higher death risk. A mother infected with P. falciparum also known as congenital malaria can pass the disease to her baby at birth.
Since Malaria infects the blood, it can also be transmitted through:
1. an organ transplant
2. a transfusion
3. use of shared needles or syringes
The symptoms of malaria develop within 10 days to 4 weeks after the infection. There are a few rare cases where the malarial parasites enter the body but remain dormant for a long period of time.
Common symptoms of malaria include:
1. chills ranging from moderate to severe
2. high fever and severe headache
3. sweating and muscle pain
4. Nausea and vomiting
5. abdominal pain
6. diarrhea and bloody stool
Why are Pregnant Women at a higher risk?
Due to the changes in a woman’s immune system during pregnancy along with the presence of a new organ namely the placenta, which is an ideal location for parasites, pregnant women may lose some of their immunity to malaria infection.
Adults who have survived malaria infections throughout their lifetimes may become partially immune to severe or fatal malaria however malaria infection during pregnancy stages have adverse effects on both mother and fetus ranging from maternal anemia, fetal loss, premature delivery, intrauterine growth retardation, delivery of low birth-weight infants along with a high-risk factor for death.
In terms of being exposed to the infection, women in their first and second pregnancies or women who are HIV-positive are likely to undergo consequences.
The adverse problems of malaria vary by transmission level depending on the type of malaria transmission area which is categorized under stable (high) or unstable (low) transmission.
In high-transmission areas for malaria, the baseline immunity to malaria is decreased by pregnancy. A non-immune pregnant woman is likely to develop a severe form of illness and complications such as-
1. Anaemia: It is a condition where a mother’s blood does not have sufficient healthy red blood cells to carry oxygen to the tissues and the baby. During pregnancy, a mother’s body is required to produce more blood to support the growth and development of her baby; however, if the body lacks iron or certain nutrients, the production of red blood cells is not possible.
2. Increased risk of hypoglycaemia, a condition where there is abnormally low levels of glucose in the blood.
4. Acute pulmonary oedema is a condition where fluid is accumulated in the interstitium and alveoli. This condition prevents the diffusion of gases, reduces blood oxygen, and increases CO2. When a pregnant woman is in contact with this condition and is not diagnosed or treated promptly, it may lead to death for both mother and the child.
Both P. falciparum and P. vivax cause complications that can affect the fetus. Common problems result in unfavourable consequences such as-
2. Premature delivery.
4. Intrauterine growth restriction.
5. Low birth weight – common.
6. Intrauterine fetal death.
Neonatal and infant problems related to malaria
1. Increased mortality rates.
2. Congenital malaria presents fever, irritability, feeding difficulties, jaundice, or anaemia.
3. Increased rates of other infections in adulthood
Despite not having a specific vaccine to prevent malaria during pregnancy, listed below are the possible measures-
1. Using insecticide-treated bed nets or sleeping under a mosquito net.
2. Receiving iron/ folate supplements against anemia.
4. Consumption of folic acid supplements in moderate quantities to prevent defects in their infants
5. Using bug sprays to prevent infection
In conclusion, it is important to talk to a healthcare professional about long-term prevention if you live in an area where malaria is common during pregnancy.