Artemisine MedicinesWhy pregnancy changes everything
Malaria in pregnancy increases the risk of severe anaemia in the mother and of miscarriage, stillbirth, prematurity and low birth weight. In stable-transmission areas, infected pregnant women may have no symptoms at all while parasites quietly damage the placenta — which is why prevention matters as much as treatment.
Prevention: IPTp with SP
WHO recommends intermittent preventive treatment in pregnancy (IPTp) with a strong recommendation: in malaria-endemic areas, pregnant women of all gravidities should receive antimalarial medicine at predetermined intervals. In practice this means full treatment doses of sulfadoxine-pyrimethamine (SP) given at scheduled antenatal-care contacts, starting as early as possible in the second trimester, at least one month apart.
Treatment: what is safe in each trimester
- Uncomplicated malaria: WHO recommends artemether-lumefantrine in all trimesters — including the first (2022 update). Other ACTs may be considered if AL is unavailable, given quinine's poorer tolerability.
- Severe malaria: pregnant and breastfeeding women are treated exactly like other severe-malaria patients — injectable artesunate first-line.
- Primaquine caution: primaquine (used against relapsing malaria and transmission) is not given in pregnancy; weekly chloroquine chemoprophylaxis can be used until after delivery and breastfeeding where relevant.
Procurement notes
Antenatal programs need reliable SP supply for IPTp plus AL stock for confirmed cases. Note that artesunate+SP and artesunate-pyronaridine are not recommended in the first trimester — check national guidelines when assembling pregnancy-focused product mixes.
Source: summarised in plain language from the WHO Guidelines for Malaria (10 September 2026), World Health Organization. This guide is for buyer education only — clinical decisions must follow the locally approved product insert and national treatment guidelines.
