Malaria in pregnancy and its potential impact on neurodevelopment in children: a systematic review.

Background: Malaria during pregnancy can have adverse effects on fetal development, but its impact on neurodevelopment remains unclear. Although some studies have explored the consequences of prenatal malaria, gaps persist due to inconsistencies in exposure timing, assessment methods, and study designs.

Methods: This systematic review highlighted the gaps in six studies selected from an initial pool of 2029 articles, offering clearer insights into the neurodevelopmental outcomes of prenatal malaria exposure.

Results: Studies from Uganda, Benin, Ghana, and Malawi show that malaria during pregnancy adversely impacts cognitive, motor, and behavioral development. Cognitive deficits were observed at 12 and 24 months, with some studies indicating long-term effects at 36 months. Motor development and language outcomes were variable, with language impairments linked to malaria acquired late in pregnancy.

Conclusions: The review identifies gaps in research, such as the role of asymptomatic infections, exposure timing, and malaria's interaction with maternal comorbidities like HIV. Potential mechanisms for neurodevelopmental deficits include placental dysfunction and inflammation impacting fetal brain development. However, methodological limitations, such as varying assessment tools and sample sizes, prevent conclusive evidence. The review calls for more longitudinal studies to understand the long-term effects of prenatal malaria better and guide interventions to improve child development in malaria-endemic regions.

Impact: Prenatal malaria exposure is linked to cognitive deficits, with potential long-term effects on motor and language development. Late pregnancy malaria may have a stronger impact on language development, highlighting the importance of exposure timing. Mechanisms such as placental dysfunction and inflammation may disrupt fetal brain development and contribute to neurodevelopmental deficits. Future studies should prioritize longitudinal research using advanced methodologies to better understand the long-term effects of prenatal malaria exposure on neurodevelopment.