Zainabur Rahmah


Malaria is an infectious disease remains a major health problem in the world. Malaria attacks without differentiating individual age and sex of pregnant women are no exception. Pregnant women have a risk of malaria by Plasmodium parasites is more severe in comparison with non-pregnant women. When a pregnancy will occur immunosuppression both humoral and cellular purpose of this paper is to discuss the mechanism of occurrence of malaria in pregnancy and its consequences on the mother and fetus. Parasite adhesion receptors Chondroitin Sulfate A (CSA) and Hyaluronic Acid (HA) in the placenta can trigger an inflammatory process involving the secretion of cytokines. Inflammatory component that appears after the accumulation of parasites in the placenta is associated with immune pathology in the Pregnancy-Associated Malaria (PAM), such as thickening of the membrane cytotrophoblasts that disrupt blood flow, inhibiting the transfer of IgG across the placenta and the exchange of nutrients from mother to fetus, causing lesions in the placenta. Malaria infection during pregnancy is a process of mediation by protein cytoadherence in Plasmodium falciparum erythrocyte membrane protein-1 (PfEMP-1) encoded by genes that bind to receptors on Var2CSA this causes placental sequestration of infected erythrocytes on endothelial cells resulting in anemia in pregnant while on fetus causes low birth weight, premature birth and stillbirth.

Full Text:



World Health Organization. 2008. The Malaria Report. http;

Departeman Kesehatan RI. 2008. Data Daerah Endemik Indonesia:

Rogerson SJ;Hviid. L; Duffy.PE. 2007. Malaria in Pregnancy: Pathogenesis and Immunity. Lancent zintect Dis: 105-17,Vol.7.

Bowen JA. 2000. The role of integrins in reproduction. Proc Soc Exp Biol Med. 223(4): 31-43

Ndam and Deloron. 2007. Review Article Molecular Aspects of Plasmodium falciparum Infection During Pregnancy. Hindawi Publishing Corporation Journal of B of iomedicine and Biotechnology. 13(10):1155.

Frevert, U and Nurdin E. 2005. Arrest in the Liver-Genetically Defined Malaria Vaccine? Clinical Implication of Basic Research. N.Engl.J. Med. (352).

Korenromp, E.L., Williams, B.G., Gouws, E., Dye, C. & Snow, R.W. 2003. Measurement of Trends in Childhood Malaria Mortality in Africa: an Assessment of Progress Toward Targets Based on Verbal autopsy. Lancet Infectious Diseases 3, 349-58.

World Health Organisation. 2005. World Malaria Report 2005.,malaria.html.

Pijnenborg, R., Vercruysse, L., Hanssens, M. 2006. The Uterine Spiral Artery in Human Pregnancy Facts and Controversies. Placenta. 27:939-958.

Davis, R. 2002. History of Malaria. RPH Lab. Medicine. http:// www.≠top.

Departeman Kesehatan RI. 2005. Data Daerah Endemik Indonesia:

Departeman Kesehatan RI. 2008. Data Daerah Endemik Indonesia:

CDC (Center for Disease Control and Prevention). 2006. Schema of The Life Cycle of Malaria. National for Infectious Diseases, Dvision of Parasitic Diseases, Division of Parasitic Diseases. (online).

Garcia JE; Puentes A and Patarroyo ME. 2006. Developmental Biology of Sporozoite-Host Interactions in Plasmdium falciparum Malaria: Implications for Vaccine Design. Clin. Micro. Rev. Oct :686-707

Vignali M; Speake C; Duffy PE. 2009. Malaria sporozoite proteome leaves a trail. Genome Biology, 10:216 (doi:10.1186/gb-2009-10-4-216).

Laminkara AA; Brown D; Potocnik A. 2007. Malaria Anemia: On Mice and Man. Blood,110:18-28.

Abraham EG and Jacobs-Lorena M. 2004. Mosquito Midgut Barriers to Malaria Parasite development. Insect Biochem Mol Biol. 34(7): 667-671.

Ghosh A, Srinivasan P, Abraham EG, Fujioka H and Jacobs-Lorena M..2003. Molecular Strategies to Study Plasmodium-mosquito Interactions. Trends Parasitol. 19(2):94-101.

Whlgren and Perlman. 2005. Malaria Melecular and Clinical Aspects. Taylor and Francis e-Library Amsterdam The Netherlands.

Costa F. TM; Lopes S. CP; Ferrer M; Leite JA; Jaular LM; Bernabeu M; Nogueira PA; Mourao M.PG; Becerra. CF; Nogueira PA; Portillo, H. 2011. On Cytoadhesion Plasmodium Vivax; Raison D’etre ?. Mem Inst Oswaldo Cruz. Rio de oswaldo, Cruz. Rio de Janeiuro. Vol. 106(Suppl)

Miller LH; Baruch DI; Marsh K; Doumbo OK. 2002. The Pathogenic Basis of Malaria.Nature. (415); 673-679.

Miller LH; Baruch DI; Marsh K; Doumbo OK. 2002. The Pathogenic Basis of Malaria.Nature. (415); 673-679.

Kirchgatter, K; Portillo, H.A. 2005. Clinical and Moleculer spect of Severe Malaria. Anais da Academia Brasileira de Ciencias. 77(3): 455-475.

Costa F,TM; Lopes S, CP; Ferrer M; Leite J,A; Jaular, Lorena Martin; Bernabeu M; Nogueira P, A; Mourao P, G; Becerra Fernandez, C; , RioLacerda M, VG; Avril M; Nogeira; Gysin, J. 2006. Cytoadhesion of Plasmodium falciparum-Infected Erythrocytes and the Infected Placenta : a Two-Way Patway. Brazilian Journal of Medical and Biological Research. 39:1525-1536.

Christine M; Cserti; Walter H; Dzik. 2007. The ABO blood group system and Plasmodium falciparum malaria. Blood October 1;110(7):2250-2258. Full text at

Miller LH; Baruch DI; Marsh K; Doumbo OK. 2002. The Pathogenic Basis of Malaria.Nature. (415); 673-679.

Chaouat, G., Le´de´e-Bataille, N., Zourbas, S., Ostojic, S., Dubanchet, S., Martal, J., Frydman, R., 2003. Cytokines, Implantation and Early Abortion: Re-examining the Th1 /Th2 Paradigm Leads to Question the Single Pathway, single therapy concept. Am J Reprod Immunol. 50:177–186.

Smith J.D; Deitsch K.W. 2004. Pregnancy-associated Malaria and the Prospects for Syndrome-specific Antimalaria Vaccines. Published November 1, 2004 // JEM vol. 200 no. 9 1093-1097.

Beeson, JG; Osier , H.H.A; Engwerda, CR. 2008.Recent Insights Into Humoral and Cellular Immune Responses Against Malaria. Review. J. Parasitol. 38,S17-S98.

O’Neil-Dunne I; Achur RN; Agbor-Enoh ST; Valiyaveettil M; Naik RS; Ockenhouse CF. 2001. Gravidity-Dependent Production of Antibodies that Inhibit Binding of Plasmodium falciparum-Infected Erythrocytes to Placental Chondroitin Sulfate Proteoglycan During Pregnancy. Infect Immun; 69:7487-7492.

Megnekou R; Staalsoe T; Taylor DW; Leke R; Hviid L. 2005. Effects of Pregnancy and Intensity of Plasmodium falciparum Tranmissin on Immonoglobulin G Sublass Responses to Variant Surface Antigens. Infect Immun. 73:4112-4118.

Elliott SR; Duffy MF; Byrne TJ; Beeson JG; Mann EJ; Wilson DW. 2005. Cross-Reactive Surface Epitopes on Chondroitin Sulfate A-Adherent Plasmodium falciparum-infected Erythrocytes are Associated with Transcription of var2csa, Infect Immun: 73:2848-2856.

Saito.S; Nakashima. A; Shima T; Ito M. 2010. Th1/Th2/Th17 and Rgulatory T-Cell Paradigm in Pregnancy. Am J Reprod Immunol; 63;601-610.

Arruvito, L., Sanz, M., Banham, A.H., Fainboim, L. 2007. Expansion of CD4+CD25+ and FOXP3+ Regulatory T Cells During the Follicular Phase of the Menstrual Cycle: Implications for Human Reproduction. J Immunol. 1(78) : 2572–2578.

Suguitan AL; Rose Jr; Leke, GF; Fouda G; Zhou A; Thuita L; Melenou S; Fogako J; Megnekou R; Taylor. 2003a. Changes in The Levels of Chemokines and Cytokines in the Placentas of Women with Plasmodium falciparum. The Journal of Infections Diseases: 188: 1074-82.

Kane EG; Andrew W; Taylor-Robinson. 2011. Prospects and Pitfalls of Pregnancy-Associated Malaria Vaccination Based on the Natural Immune Response to Plasmodium falciaprum Var2CSA-Expressing Parasites

Mens PF; Bojtor EC; Henk DFH; Schalling. 2010. Moleculer Interactions in The Placenta During Malaria Infection. European Journal af Obstetrics and Gynecology and Reproductive Biology 152.126-132.

Chaisavaneeyakorn, S., Moore, J.M., Othoro, C. 2005. Immunity to Placental Malaria. IV. Placental is Associated with Up-regulation of Macrophage Migration Inhibitory Factor in Intervilous Blood.J Infect Dis. 186:1371-5.

Chaouat, G., Le´de´e-Bataille, N., Zourbas, S., Ostojic, S., Dubanchet, S., Martal, J., Frydman, R., 2003. Cytokines, Implantation and Early Abortion: Re-examining the Th1 /Th2 Paradigm Leads to Question the Single Pathway, single therapy concept. Am J Reprod Immunol. 50:177–186.

Suguitan AL; Cadigan TJ; Nguyun TA. 2003b. Malaria-associated Cytokine Changes in the Placental of Women with Pre-term Deliveries in Yaounde. Cameroon. Am J Trop Med Hyg;69:574-81.

Armorsolo L; Suguitan Jr; Timothy JC; Thu AN; Zhou A; Robert JIL; Metenou S; Thuita L; Megnekou R; Fogako J; Rose GFL; Taylor DW. 2003. Malaria-Associated Cytokine Changes In the Plasenta of Women With Pre-term Deliveries in yaounde. Cameroon, Am.J.Trop. Med. Hyg, 69 (6) :574-581.

Neres R. Marinho C.R.F; Goncalves L.A; Catarino M B; Penha-Goncalves. 2007. Pregnancy Outcome and Placenta Pathology in Plasmodium berghei ANKA Infected Mice Reproduce the Pathogenesis of Severe Malaria in Pregnant Women. PLOS ONE 3(2): e1608. Doi:10.1371/journal. Pone.0001608.

Menendez C, Ordi J, Ismail MR, Ventura PJ, Aponte JJ, Kahigwa E, Font F, Alonso PL: The impact of placental malaria on gestational age and birth weight. J Infect Dis 2000, 181:1740-1745.

Calleja-Agius J & Brincat, M.P. 2008. Recurrent Miscarriages: What is the Role of Cytokines? Gynecological Endocrinology. 24 (120). 663–668

Darrasse-Je`ze, G., Klatzmann, D., Charlotte, F., Salomon, B.L., Cohen, J.L. 2006. CD4+CD25+ Regulatory/Suppressor T cells Prevent Allogeneic Fetus Rejection in Mice. Immunol Lett; 102:106–109



  • There are currently no refbacks.

Editorial Office:

Faculty of Medical and Health Sciences,
Universitas Islam Negeri Maulana Malik Ibrahim
Jalan Ir. Soekarno No.34 Dadaprejo, Batu, Jawa Timur, Indonesia
Phone (+62) 85746163772, (+62) 85259506000, Faximile (+62) 341 558933

Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.