Pregnancy-associated malaria: Linking knowledges to human and rodent studies

Abstract

　 Pregnant women are highly susceptible to malaria infection because of their low immunity, and are at increased risk of maternal illness or death, in addition to spontaneous abortion, stillbirth, premature delivery and low birth weight. Pregnancy-associated hormones are involved in physiological changes, such as immune tolerance and metabolic adaptations, during pregnancy. It is considered that metabolic adaptations are also associated with the susceptibility to malaria parasites during pregnancy.
　 Placental malaria is characterized by the accumulation of infected erythrocytes and inflammatory cells in the placenta. Placental malaria has been reported to be correlated with adverse pregnancy outcomes such as fetal growth restriction, still birth, premature delivery and, possibly, preeclampsia. Recently, we suggested that IFNGR1 signaling plays a pivotal role in placental pathology and subsequent adverse pregnancy outcomes during severe malaria. However, the details of pathophysiology and pathogenesis of malaria parasites during pregnancy are poorly understood. Therefore, it is difficult to detect malaria parasites early during pregnancy and precaution against severe malaria. This review summarizes the evidence from human and rodent studies of pregnancy-associated malaria.