KIU Publications

Malaria in pregnancy remains a major public health concern in sub-Saharan Africa, where transmission intensity is high and pregnant women are particularly vulnerable to infection. Physiological and immunological changes during pregnancy increase susceptibility to Plasmodium falciparum, leading to adverse maternal and fetal outcomes. Intermittent preventive therapy in pregnancy has been adopted as a core strategy to reduce malaria burden and improve birth outcomes. The purpose of this review was to critically examine the biochemical and pathophysiological basis of malaria in pregnancy, assess the effectiveness of intermittent preventive therapy, and evaluate its impact on malaria-related birth outcomes among pregnant women in sub-Saharan Africa. This article was developed through a narrative review of peer-reviewed literature focusing on malaria pathogenesis, pharmacology of preventive therapy, and maternal and neonatal outcomes. Evidence indicated that intermittent preventive therapy significantly reduced placental parasitemia, maternal anemia, low birth weight, and preterm delivery, although effectiveness is influenced by drug resistance, coverage gaps, and health system challenges. Intermittent preventive therapy remained a highly effective intervention for improving pregnancy outcomes in malaria-endemic regions, but sustained optimization of implementation and surveillance is essential to maintain its benefits.