Por Renan Filho · 2026-10-24
**Lead**
Every year, millions of pregnant women in malaria-endemic regions face a silent but deadly threat. Infection with the Plasmodium parasite during pregnancy significantly raises the risk of maternal anaemia, stillbirth, preterm delivery and low birth weight. Despite being both preventable and treatable, malaria in pregnancy continues to exact a heavy toll on maternal and child health, particularly in sub-Saharan Africa. For the United Kingdom — a country with growing numbers of travellers visiting endemic areas, a sizeable diaspora community and a longstanding commitment to global health — understanding what happens when malaria strikes during pregnancy is not just a distant concern but a pressing public health issue.
**Context**
Malaria is caused by parasites transmitted through the bite of infected female Anopheles mosquitoes. The most dangerous species, Plasmodium falciparum, is responsible for the majority of severe cases and deaths. When a pregnant woman is infected, the parasites can sequester in the placenta, triggering an inflammatory response that impairs oxygen and nutrient transfer to the foetus. This placental malaria is a key driver of adverse birth outcomes.
According to the World Health Organization, malaria in pregnancy is a major cause of maternal morbidity and neonatal mortality in endemic areas. Pregnant women are more attractive to mosquitoes and have reduced immunity to malaria, making them three times more likely to develop severe disease than non-pregnant women. The consequences cascade: maternal anaemia weakens the mother and increases the risk of haemorrhage; low birth weight predisposes infants to infections and developmental delays; and stillbirth remains a tragically common outcome in high-transmission settings.
The UK is not malaria-free in terms of imported cases. Public Health England data (now UK Health Security Agency) consistently records around 1,500 to 2,000 imported malaria cases each year, with a small but significant proportion occurring in pregnant women — often recent migrants visiting friends and relatives in their country of origin, or travellers who did not take adequate prophylaxis. The NHS advises that women who are pregnant or planning pregnancy should avoid travel to malaria-endemic areas if possible, and if travel is unavoidable, they must use insecticide-treated nets and take antimalarial medication deemed safe in pregnancy, such as chloroquine or mefloquine (depending on resistance patterns).
**Analysis**
The impact of malaria in pregnancy extends far beyond the individual mother and child. It perpetuates cycles of poverty and ill health, as families lose breadwinners, mothers face long recovery times, and children born with low birth weight may require costly neonatal care. In endemic countries, intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) has been a cornerstone of antenatal care, dramatically reducing rates of maternal anaemia and low birth weight. However, growing parasite resistance to SP threatens these gains, prompting research into alternative regimens.
For the UK, the issue is twofold. Domestically, clinicians must remain vigilant when treating pregnant women with fever who have recently travelled. Late diagnosis can be fatal. The National Travel Health Network and Centre (NaTHNaC) provides updated guidelines for prophylaxis, and obstetricians are trained to consider malaria in differential diagnoses. Internationally, the UK government has been a significant donor to the Global Fund to Fight AIDS, Tuberculosis and Malaria and supports research into new tools such as the RTS,S/AS01 (Mosquirix) vaccine, which has shown partial efficacy and is being rolled out in several African countries. The vaccine, while not a silver bullet, could reduce the burden of severe malaria in children and, indirectly, the number of infected women entering pregnancy.
Another dimension is climate change. As temperatures rise, the range of Anopheles mosquitoes may expand, potentially bringing malaria transmission closer to southern Europe. While the UK is not currently at risk of endemic transmission, sporadic local cases have occurred, and changing climate patterns could increase the likelihood of mosquito-borne diseases in the future. This adds a layer of urgency to maintaining robust public health surveillance and preparedness.
**Fontes**
World Health Organization (WHO) – Malaria in Pregnancy fact sheet and Global Malaria Programme reports. UK Health Security Agency (UKHSA) – imported malaria surveillance data and travel health advice. National Travel Health Network and Centre (NaTHNaC) – guidelines on malaria prophylaxis in pregnancy. The Lancet – peer-reviewed studies on placental malaria and intermittent preventive treatment. Malaria Consortium – research on community-based interventions for malaria in pregnancy.