Insecticide-treated nets for preventing malaria in pregnancy

In endemic areas, malaria in pregnancy is a major public health problem. It contributes to severe anaemia in the mother and low birth weight for babies, which are associated with poor infant health and early infant death. Also the unborn child and the pregnant woman may die from malaria in pregnancy. Protection with insecticide-treated bednets (ITNs) during pregnancy is widely advocated, but evidence of their benefit has been inconsistent. This review found five trials of ITNs in pregnant women. The four trials in sub-Saharan Africa compared ITNs with no nets and showed a benefit from ITNs in terms of fewer malaria infections, low birthweight babies, and fewer babies died before delivery. The effects on severe anaemia in the mothers were inconclusive. The one trial from Asia compared ITNs with untreated nets and showed a beneficial effect on anaemia in women and fewer babies died before delivery, but it had no impact on other outcomes. ITNs have been shown to be beneficial and should be included in strategies to try to reduce the adverse effects of malaria in pregnant women in endemic areas of the world.