Department of Family and Preventive Medicine, Emory University School of Medicine, Atlanta, GA, USA.
Air Force Institute of Technology, Wright-Patterson Air Force Base, OH, USA.
J Travel Med. 2020 Jul 14;27(4). doi: 10.1093/jtm/taaa074.
Pregnant travelers face numerous risks, notably increased susceptibility to or severity of multiple infections, including malaria. Because pregnant women residing in areas non-endemic for malaria are unlikely to have protective immunity, travel to endemic areas poses risk of severe illness and pregnancy complications, such as low birthweight and fetal loss. If travel to malaria-endemic areas cannot be avoided, preventive measures are critical. However, malaria chemoprophylaxis in pregnancy can be challenging, since commonly used regimens have varying levels of safety data and national guidelines differ. Furthermore, although chloroquine and mefloquine have wide acceptance for use in pregnancy, regional malaria resistance and non-pregnancy contraindications limit their use. Mosquito repellents, including N,N-diethyl-m-toluamide (DEET) and permethrin treatment of clothing, are considered safe in pregnancy and important to prevent malaria as well as other arthropod-borne infections such as Zika virus infection. Pregnant travelers at risk for malaria exposure should be advised to seek medical attention immediately if any symptoms of illness, particularly fever, develop.
孕妇面临许多风险，尤其是更容易感染多种感染，包括疟疾。由于居住在非疟疾流行地区的孕妇不太可能具有保护性免疫力，因此前往疟疾流行地区可能会导致严重疾病和妊娠并发症，例如低出生体重和胎儿丢失。如果无法避免前往疟疾流行地区，预防措施至关重要。然而，妊娠期间的疟疾化学预防可能具有挑战性，因为常用方案的安全性数据水平不同，国家指南也存在差异。此外，尽管氯喹和甲氟喹在妊娠期间广泛被接受使用，但区域疟疾耐药性和非妊娠禁忌症限制了它们的使用。驱虫剂，包括 N,N-二乙基间甲苯酰胺（DEET）和驱虫剂处理的衣物，在妊娠期间被认为是安全的，对于预防疟疾以及其他节肢动物传播的感染（如寨卡病毒感染）非常重要。对于有疟疾暴露风险的孕妇，应建议她们如果出现任何疾病症状，特别是发热，立即寻求医疗帮助。
