Impact of Malaria in Pregnancy on Risk of Malaria in Young Children: Systematic Review and Meta-Analyses

Abstract Background Our objective was to quantify the risk of acquiring malaria among progeny of women with malaria during pregnancy. Methods We searched MEDLINE, EMBASE, CINAHL, and the Cochrane Library for eligible prospective studies. The primary predictor was malaria during pregnancy defined as placental malaria, parasitemia, clinical malaria, or pregnancy-associated malaria. Primary outcomes were parasitemia or clinically defined malaria of young children. We performed meta-analyses to pool adjusted risk estimates using a random-effects model. Results Nineteen of 2053 eligible studies met inclusion criteria for the systemic review. Eleven of these studies were quantitative and were included in the meta-analyses. The pooled adjusted odds ratio (aOR) or adjusted hazard ratio (aHR) of malaria during pregnancy for detection of parasitemia in young children were 1.94 (95% confidence interval [CI], 0.93–4.07; P = .08) and 1.46 (95% CI, 1.07–2.00; P < .001), respectively. The pooled aOR or aHR for clinically defined malaria in young children were 2.82 (95% CI, 1.82–4.38; P < .001) and 1.31 (95% CI, 0.96–1.79; P = .09), respectively. Conclusions Our results confirmed that malaria during pregnancy significantly increased the overall risk of malaria in young children via indeterminate mechanisms and emphasize the urgent need to implement safe and highly effective strategies to prevent malaria during pregnancy. Meta-analyses of 11 eligible studies were performed to estimate the adjusted risk of acquiring malaria among offspring of women with malaria during pregnancy. The results confirmed that malaria during pregnancy significantly increased the overall risk of malaria in young children.