Dipartimento di Scienze Biomediche, Chirurgiche e Odontoiatriche, Università degli Studi di Milano, 20133 Milan, Italy.
Dipartimento di Scienze e Politiche Ambientali, Università degli Studi di Milano, 20133 Milan, Italy.
Molecules. 2020 Jul 31;25(15):3505. doi: 10.3390/molecules25153505.
Artemisinin combination therapy (ACT) is recommended by the World Health Organization (WHO) as first line treatment for uncomplicated malaria both in adults and children. During pregnancy, ACT is considered safe only in the second and third trimester, since animal studies have demonstrated that artemisinin derivatives can cause foetal death and congenital malformation within a narrow time window in early embryogenesis. During this period, artemisinin derivatives induce defective embryonic erythropoiesis and vasculogenesis/angiogenesis in experimental models. However, clinical data on the safety profile of ACT in pregnant women have not shown an increased risk of miscarriage, stillbirth, or congenital malformation, nor low birth weight, associated with exposure to artemisinins in the first trimester. Although further studies are needed, the evidence collected up to now is prompting the WHO towards a change in the guidelines for the treatment of uncomplicated malaria, allowing the use of ACT also in the first trimester of pregnancy.
青蒿素类复方疗法（ACT）被世界卫生组织（WHO）推荐为成人和儿童治疗无并发症疟疾的一线疗法。在怀孕期间，只有在第二和第三孕期，ACT 才被认为是安全的，因为动物研究表明，青蒿素衍生物在早期胚胎发生的狭窄时间窗口内会导致胎儿死亡和先天畸形。在此期间，青蒿素衍生物在实验模型中诱导胚胎期红细胞生成和血管生成/血管生成缺陷。然而，关于孕妇中 ACT 的安全性概况的临床数据并未显示与接触青蒿素有关的流产、死产或先天畸形风险增加，也没有与出生体重低相关。尽管需要进一步研究，但迄今为止收集的证据促使世卫组织改变了治疗无并发症疟疾的指南，允许在妊娠的第一孕期也使用 ACT。
