[1][2][3][4] Placental malaria interferes with the transmission of vital substances through the fetal placenta, which can result in stillbirths, miscarriages, and dangerously low birth weights.
[8][9] Symptoms of malaria include malaise, headaches, fatigue, fever, muscle aches, abdominal pain, nausea and vomiting.
Pregnant women and unborn fetuses are more susceptible to malaria infection due to the complications of pregnancy and the aggregation of erythrocytes around the placenta.
[16] P. falciparum expresses proteins on the surface of parasite-infected erythrocytes (IE) helping them bind to an unusually low-sulfated form of chondroitin sulfate A (CSA) in the placental intervillous space.
Some studies have suggested that iron supplementation can help with maternal anemia, but more research on malaria-endemic regions is required to make a better recommendation for mothers with PAM.
[30][needs update] One systematic review showed that children of women with PAM are also more likely to contract clinical malaria and P. falciparum parasitaemia, although the reasoning for this is uncertain.
[39] Treatment of PAM is highly dependant on the mother's current pregnancy stage (i.e. trimester) and the species responsible for the disease transmission.
[citation needed] For infection caused by P. falciparum, the WHO recommends a first trimester a treatment consisting of both Quinine and Clindamycin for a duration of 7 days.
[11] Due to the nature of disease transmission (i.e. via mosquitoes) and life cycle of the parasite, malaria is prevalent in warm, humid climates, such as tropical and subtropical regions.
[44] Consistent with previous years, the incidence of malaria in general is greatest in African regions, specifically sub-Saharan Africa, as defined by the World Health Organization - (WHO) - although there was a decline in numbers from 2010 to 2018.
[29][46] On the contrary, women who live in areas with lower transmission are at a very high risk of adverse malarial outcomes despite their number of pregnancies.
By measuring circulating levels of IgG antibodies that presumably target VAR2SCA, the study demonstrated that subsequent pregnancies confer progressively greater protection to PAM.
[50] Additional genetic testing relating to pregnancy-associated malaria is currently being researched which involves looking at glucose-6-phosphate dehydrogenase - (G6PD) - an enzyme responsible for keeping red blood cells protected from being destroyed too soon by foods, medications, etc.
[52] Although these drugs would most likely be used after delivery for treatment of pregnancy-associated malaria, this type of genetic testing can help avoid inducing anemia in women more prone to red blood cell breakdown.
PAMVAC is based on a recombinant form of the VAR2CSA domain and has been shown to be well-tolerated when injected in malaria-naive volunteers while also successfully inducing the production of antibodies in opposition against VAR2CSA.
[53][54] A second vaccine candidate against pregnancy-associated malaria called PRIMVAC is also currently undergoing clinical trials in healthy adult women as a 3-dose course.
In preclinical studies, PRIMVAC injected into rats led to the production of antibodies against VAR2CSA on infected erythrocytes and also resulted in reduction of their binding to CSA.