The harmful effects of malaria (mainly due to P. falciparum) during pregnancy — maternal anemia,low birth weight,and preterm birth—have long been recognized. In areas of stable endemic transmission (e.g., sub-Saharan Africa), up to 25% of pregnant women have acute infection, leading to placental malaria ; this frequency is higher than that among nonpregnant women. In several Studies in Africa and Asia, the prevalence of malarial parasitemia was found to be higher among pregnant females than among nonpregnant females to 45 years of age. P.falciparum is the only species associated with placental sequestration, which is believed to be the cause of many of the manifestations of P.falciparum disease during pregnancy. Many studies have shown decreasing susceptibility to malaria with increasing parity,probably as a result of acquisition of immunity to parasites expressing pregnancy-specific variant surface antigens. This association is most pronounced in areas where malaria is highly endemic. Young maternal age may be an additional and independent risk factor for malaria
During pregnancy.The third Trimester of gestation has been associated with The highest risk of clinical
Malaria in some studies but not others. However, maternal parasitemia, Placental parasite burden, and
Episodes of clinical malaria may be expressions of disease severity rather than of initial susceptibility
In areas with a high prevalence of malaria.