Malaria in pregnancy shapes the development of foetal and infant immunity

Abstract

Malaria in pregnancy remains one of the most important causes of adverse birth outcomes. In addition to the profoundly deleterious impact of maternal malaria on the health of the mother and fetus, malaria infection in pregnancy has been shown to affect the development of the fetal and infant immune system and may alter the risk of malaria and non‐malarial outcomes during infancy. This review summarizes our current understanding of how malaria infection in pregnancy shapes the protective components of the maternal immune system transferred to the fetus and how fetal exposure to parasite antigens impacts the development of fetal and infant immunity. It also reviews existing evidence linking malaria infection in pregnancy to malaria and non‐malarial outcomes in infancy and how preventing malaria in pregnancy may alter these outcomes. A better understanding of the consequences of malaria infection in pregnancy on the development of fetal and infant immunity will inform control strategies, including intermittent preventative treatment in pregnancy and vaccine development.