Background

Malaria during pregnancy is associated with a greater risk of complications for the mother and fetus. The aim of the study is to analyze the features of imported cases of malaria in pregnant women in Europe and evaluate which factors are associated with a non-favourable outcome.

Methods

A computerized search of the literature was performed combining the terms plasmod*, malaria, pregnan*, maternal, gravid, parturient, expectant, and congenital, from January 1997 to July 2023.

Results

28 articles reporting 57 cases of malaria in pregnant women immigrant in non-endemic areas were included. The patients mainly came from Sub-Saharan Africa. There were 10 asymptomatic cases, while the predominant clinical syndrome among the symptomatic women was fever associated with anaemia. The median latency period from permanence in endemic areas and diagnosis in European countries was 180 days (IQR 15–730). Pregnancy outcomes were favourable in 35 cases (61 %): all term pregnancies, no low-birth-weight newborns. There were 4 abortions; 1 child was delivered pre-term; 7 babies were reported to have a low birth weight; 10 cases of congenital malaria were documented. P. falciparum was found with a higher frequency in women with a favourable outcome, while P. vivax was, in all cases, associated with a worse prognosis.

Conclusions

Diagnosis of malaria in pregnant woman in non-endemic countries may be challenging and a delay in diagnosis may lead to an adverse outcome. Screening for malaria should be performed in pregnant women from endemic areas, especially if they present anaemia or fever.

中文翻译：

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欧洲妊娠期输入性疟疾：过去 25 年文献的系统回顾

背景

怀孕期间患疟疾会增加母亲和胎儿出现并发症的风险。该研究的目的是分析欧洲孕妇输入性疟疾病例的特征，并评估哪些因素与不良结果相关。

方法

我们对 1997 年 1 月至 2023 年 7 月期间的文献进行了计算机检索，结合了疟原虫*、疟疾、怀孕*、孕产妇、妊娠、产妇、预期和先天性等术语。

结果

纳入 28 篇文章，报告 57 例非流行地区孕妇移民疟疾病例。患者主要来自撒哈拉以南非洲地区。有 10 例无症状病例，而有症状女性的主要临床症状是发热伴贫血。在欧洲国家，从流行地区持续存在到诊断的中位潜伏期为 180 天（IQR 15-730）。35 例 (61%) 的妊娠结局良好：均为足月妊娠，无低出生体重新生儿。有4次堕胎；1名儿童早产；据报道，有 7 名婴儿出生体重过低；记录了 10 例先天性疟疾。恶性疟原虫在预后良好的女性中出现的频率较高，而间日疟原虫在所有情况下都与较差的预后相关。

结论

在非流行国家对孕妇进行疟疾诊断可能具有挑战性，诊断延迟可能会导致不良结果。应对疟疾流行地区的孕妇进行疟疾筛查，特别是当她们出现贫血或发烧时。