School of Biosciences, Taylor's University, Subang Jaya, Malaysia.
Department of Medicine at Royal Melbourne Hospital, Peter Doherty Institute, University of Melbourne, Melbourne, VIC, Australia.
Front Immunol. 2021 Mar 15;12:621382. doi: 10.3389/fimmu.2021.621382. eCollection 2021.
Pregnant women in malaria-endemic regions are susceptible to malaria in pregnancy, which has adverse consequences on birth outcomes, including having small for gestational age and preterm babies. These babies are likely to have low birthweights, which predisposes to infant mortality and lifelong morbidities. During malaria in pregnancy, infected erythrocytes express a unique variant surface antigen, VAR2CSA, that mediates sequestration in the placenta. This process may initiate a range of host responses that contribute to placental inflammation and dysregulated placental development, which affects placental vasculogenesis, angiogenesis and nutrient transport. Collectively, these result in the impairment of placental functions, affecting fetal development. In this review, we provide an overview of malaria in pregnancy and the different pathological pathways leading to malaria in pregnancy-associated low birthweight. We also discuss current prevention and management strategies for malaria in pregnancy, and some potential therapeutic interventions that may improve birth outcomes. Lastly, we outline some priorities for future research that could bring us one step closer to reducing this health burden.
疟疾流行地区的孕妇易患妊娠疟疾，这对分娩结局有不良影响，包括胎儿生长受限和早产。这些婴儿可能体重低，容易导致婴儿死亡和终生患病。妊娠疟疾期间，受感染的红细胞表达一种独特的变异表面抗原 VAR2CSA，介导其在胎盘内的黏附。这一过程可能引发一系列宿主反应，导致胎盘炎症和胎盘发育失调，影响胎盘血管生成、血管生成和营养物质转运。所有这些共同导致胎盘功能受损，影响胎儿发育。在这篇综述中，我们概述了妊娠疟疾以及导致妊娠疟疾相关低体重儿的不同病理途径。我们还讨论了目前妊娠疟疾的预防和管理策略，以及一些可能改善分娩结局的潜在治疗干预措施。最后，我们概述了未来研究的一些重点，这些研究可能会使我们更进一步，减轻这一健康负担。
