Malaria

Date: March 2024, Version 4

Quick read

It is very important that pregnant women who need to travel take all possible precautions to avoid catching malaria, including using anti-malarial medicines and insect repellents.

What is it?

Malaria is a potentially fatal infection spread by mosquitoes. Normal changes to the immune system mean that pregnant women are more likely to catch malaria. Malaria can cause serious pregnancy complications, including miscarriage, stillbirth, and preterm delivery. Women who are pregnant or trying to conceive are advised not travel to areas where there is a high risk of malaria.

How can I reduce the risk of malaria?

If travel to a high-risk malaria area cannot be avoided, you should do all of the following to reduce your risks of both mosquito bites and of developing malaria:

• Take an antimalarial medicine (see below)

• Use insect repellents (see below)

• Stay inside between dusk and dawn, when the type of mosquitos that carry malaria are active

• Cover up exposed skin with clothing (e.g. wear long sleeves and full-length trousers)

• Sleep with mosquito nets over your bed

Insect repellents

Insect repellents keep biting insects away and are applied to exposed skin and clothes. All people (including pregnant women) who are travelling to areas with a high risk of malaria should use an effective insect repellent such as DEET. Insect repellents are not known to be harmful to a developing baby.

For more details on use of insect repellents during pregnancy please see the insect repellents bump leaflet.

Antimalarial medicines

Antimalarial medicines reduce the chance of malaria developing if you are bitten by an infected mosquito. There are several different antimalarial medicines, including chloroquine, mefloquine, proguanil, doxycycline, and Malarone® (a combination medicine including both atovaquone and proguanil). The antimalarial medicine that you need will depend upon your travel destination and other factors. Some need to be taken for a while before and after travelling, as well as during the trip.

If you are pregnant or trying to conceive, please tell your doctor as this may affect the choice of medication. There is no strong evidence that chloroquine, mefloquine, proguanil, or Malarone® affect a baby in the womb, and it is very important to prevent malaria as it can cause severe illness and pregnancy complications. Doxycycline tends to be avoided in pregnancy where possible as it might affect the baby’s developing teeth.

Please see our bump leaflets on chloroquine, mefloquine, proguanil, and Malarone® for further details on each of these antimalarial medicines.

Will I or my baby need extra monitoring during pregnancy?

As part of their routine antenatal care most women will be offered a scan at around 20 weeks of pregnancy to look for birth defects and to check the baby’s growth.

Using insect repellents and antimalarial medicines during pregnancy is not expected to cause any problems that would require extra monitoring of your baby. However, if you have been infected with malaria during your pregnancy, closer monitoring will be necessary.

Who can I talk to if I have questions?

If you have any questions regarding the information in this leaflet, please discuss them with your health care provider. They can access more detailed medical and scientific information from www.uktis.org.

How can I help to improve drug safety information for pregnant women in the future?

Our online reporting system (MyBump Portal) allows women who are currently pregnant to create a secure record of their pregnancy, collected through a series of questionnaires. You will be asked to enter information about your health, whether or not you take any medicines, your pregnancy outcome and your child's development. You can update your details at any time during pregnancy or afterwards. This information will help us better understand how medicines affect the health of pregnant women and their babies. Please visit the MyBump Portal to register.

General information
Sadly, miscarriage and birth defects can occur in any pregnancy.

Miscarriage occurs in about 1 in every 5 pregnancies, and 1 in every 40 babies are born with a birth defect. This is called the ‘background risk’ and happens whether medication is taken or not.

Most medicines cross the placenta and reach the baby. For many medications this is not a problem. However, some medicines can affect a baby’s growth and development.

If you take regular medication and are planning to conceive, you should discuss whether your medicine is safe to continue with your doctor/health care team before becoming pregnant. If you have an unplanned pregnancy while taking a medicine, you should tell your doctor as soon as possible.

If a new medicine is suggested for you during pregnancy, please make sure that the person prescribing it knows that you are pregnant. If you have any concerns about a medicine, you can check with your doctor, midwife or pharmacist.

Our Bumps information leaflets provide information about the effects of medicines in pregnancy so that you can decide, together with your healthcare provider, what is best for you and your baby.