First-trimester malaria treatment found to be safe for pregnant women

A study led by Oxford University researchers at the Shoklo Malaria Research Unit in Thailand has found that first-trimester malarial treatment was relatively safe in pregnant women.
The researchers examined medical records of women attending the unit's antenatal clinic in the 25 years since its founding. The researchers discovered that malaria increased the risks of miscarriage from one in five pregnancies to one in two pregnancies when experiencing a single episode of malaria during the first trimester, Health Canal reports.
Even women who were infected but had no symptoms of malaria had an increased risk of miscarriage to one in three pregnancies.
Artemisinin-based combination therapy is recommended by the World Health Organization as the treatment for all malaria caused by the P. falciparum species of the malaria parasite, except in the first trimester in pregnancy. This is due to animal studies that have indicated the drugs may be toxic to embryos.
The researchers found that the likelihood of miscarriage was similar in women with chloroquinine, quinine and artemisinin and there were no differences between the treatments in other outcomes such as low birth weight or stillbirth.
"Our work has highlighted the particular risk factors with malaria infection during pregnancy," Rose McGready, the study's leader, said, according to Health Canal. "Particularly worrying is the risk of miscarriage even when the disease is asymptomatic. However, while the dangers of miscarriage are considerable, our study offers some good news – that the most common drugs reduce this risk significantly."
The researchers concluded that a randomized ACT trial is required to make recommendations on the safety of first-trimester malaria treatments with this class of drug.