(Date: February 2019. Version: 3)

This factsheet has been written for members of the public by the UK Teratology Information Service (UKTIS). UKTIS is a not-for-profit organisation funded by the UK Health Security Agency (UKHSA) on behalf of UK Health Departments. UKTIS has been providing scientific information to health care providers since 1983 on the effects that medicines, recreational drugs and chemicals may have on the developing baby during pregnancy.

What is it?

Malaria is a potentially fatal illness carried by mosquitoes. Due to the bodily changes associated with pregnancy, pregnant women are more likely to develop malaria if bitten by an infected mosquito. Pregnant women and those trying to conceive are therefore advised, wherever possible, to avoid travelling to areas where there is a high risk of catching malaria.

How can I reduce the risk of malaria?

If travel to a high risk malaria area cannot be avoided, you should do 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 the bed

All of these measures should be used together to minimise the risk of malaria.

Insect repellents

What are they?
Insect repellents contain chemicals to keep biting insects away and should be applied to clothes, exposed skin, and mosquito nets.

Is it safe to use insect repellents during pregnancy?
It is currently recommended that all people (including pregnant women) who are travelling to areas where there is a high risk of malaria use a very effective insect repellent called DEET. The small number of studies that have examined DEET use during pregnancy do not show that it is harmful. While ongoing research is ideally required to confirm these findings, the risk to you and your baby from malaria is likely to be far greater than any risk from using DEET.

For all people using DEET, it is advisable to follow the manufacturer’s instructions regarding application. It is also recommended that insect repellents are washed off once you are no longer at risk of being bitten.

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

Antimalarial medicines

What are they?
Antimalarial medicines are tablets taken to reduce the chance of malaria developing if you are bitten by an infected mosquito. There are a number of different antimalarial medicines, including chloroquine, mefloquine, proguanil, Malarone® (atovaquone-proguanil combination) and doxycycline. The antimalarial medicine that you need will depend upon your travel destination and other factors. You may need to start taking an antimalarial medicine a few weeks before you travel. Your doctor will be able to help you make decisions about the most suitable antimalarial treatment.

Is it safe to take antimalarial medicines in pregnancy?
You should not avoid taking antimalarials just because you are pregnant. It is, however, important to inform your doctor if you are pregnant or trying to conceive as this may influence the choice of medication. For example, doxycycline, if taken after the first trimester can cause a baby’s milk teeth to be permanently stained and discoloured and would therefore only be prescribed to pregnant women if no other effective antimalarial medicine is available or considered suitable.

For some antimalarial medicines, only small numbers of pregnant women have been studied and more research about possible effects is therefore ideally required. However, the risk of harm to you and your baby from malaria is likely to be far greater than any potential risk from taking an antimalarial medicine in pregnancy. Please see our bumps leaflets on chloroquine, mefloquine, proguanil, and Malarone® for details of what is known about use in pregnancy of each of these antimalarial medicines.

No antimalarial medicine is 100% effective, therefore it is very important that you also reduce the chance of being bitten by using insect repellents, mosquito nets, and covering as much skin as possible with clothing, particularly between dawn and dusk as described above.

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 about the information in this leaflet please discuss them with your health care provider. They can access more detailed medical and scientific information from  

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General information 

Up to 1 out of every 5 pregnancies ends in a miscarriage, and 1 in 40 babies are born with a birth defect. These are referred to as the background population risks.  They describe the chance of these events happening for any pregnancy before taking factors such as the mother’s health during pregnancy, her lifestyle, medicines she takes and the genetic make up of her and the baby’s father into account.

Medicines use in pregnancy

Most medicines used by the mother will cross the placenta and reach the baby. Sometimes this may have beneficial effects for the baby.  There are, however, some medicines that can harm a baby’s normal development.  How a medicine affects a baby may depend on the stage of pregnancy when the medicine is taken. If you are on regular medication you should discuss these effects with your doctor/health care team before becoming pregnant.

If a new medicine is suggested for you during pregnancy, please ensure the doctor or health care professional treating you is aware of your pregnancy.

When deciding whether or not to use a medicine in pregnancy you need to weigh up how the medicine might improve your and/or your unborn baby’s health against any possible problems that the drug may cause. Our bumps leaflets are written to provide you with a summary of what is known about use of a specific medicine in pregnancy so that you can decide together with your health care provider what is best for you and your baby.   

Every pregnancy is unique. The decision to start, stop, continue or change a prescribed medicine before or during pregnancy should be made in consultation with your health care provider. It is very helpful if you can record all your medication taken in pregnancy in your hand held maternity records.

Disclaimer: This information is not intended to replace the individual care and advice of your health care provider. New information is continually becoming available. Whilst every effort will be made to ensure that this information is accurate and up to date at the time of publication, we cannot cover every eventuality and the information providers cannot be held responsible for any adverse outcomes following decisions made on the basis of this information. We strongly advise that printouts should NOT be kept for any length of time, or for “future reference” as they can rapidly become out of date.

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