Effects of malaria in pregnancy (mip) on pregnancy development and its outcome: a Critical review

Abstract

Malaria is the most important tropical parasitic infection in humans all over the world, and very common in developing countries especially in the tropical zones. The protozoan parasites Plasmodium falciparum, P. vivax, P. malariae and P. ovaleare transmitted through the bite of sporozoite-infected female Anopheles mosquitoes to cause malaria in humans. Malaria in pregnancy (MiP) is a clinical situation in which a pregnant woman is infected with Plasmodium parasite resulting in malaria. MiP is detrimental to both the pregnant woman and her fetus, and it remains as one of the major causes of infant mortality in malaria endemic regions especially in Sub-Saharan Africa. It causes several histopathological changes within the placenta and umbilical cord which manifest in several clinical symptoms. It is one of the key contributors to preterm delivery, low birth weight, intrauterine growth retardation (IUGR), miscarriage, intrauterine death, poor neurodevelopment and immunosuppression in infants. Most distinct systemic proinflammatory responses in pregnancy are characteristics of severe malaria, and excessive activation of the immune system is central to the pathophysiology of placental malaria. There is extensive research on VAR2CSA and its contribution to placental sequestration. Currently, VAR2CSA protein is being made into pregnancy malaria specific vaccines for non-immune mothers to reduce placental malaria infection. This review summarizes the evidences, currently known clinically significant manifestations and the ultimate effect of MiP on pregnancy development