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  • Systematic Review
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Malaria in pregnancy and its potential impact on neurodevelopment in children: a systematic review

Pediatric Research (2025)Cite this article

Abstract

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.

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Fig. 1: PRISMA 2020 flow diagram for systematic review including only database and register searches.

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Acknowledgements

The authors would like to express their gratitude to the Indian Council of Medical Research - National Institute of Malaria Research (ICMR-NIMR), Government of India, for their institutional support.

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Author notes

  1. Shrikant Nema

    Present address: International Center for Genetic Engineering and Biotechnology (ICGEB) Aruna Asaf Ali Marg, 110067, New Delhi, India

Authors and Affiliations

  1. ICMR-National Institute of Malaria Research, 110077, New Delhi, India

    Shrikant Nema, Richa Singhal, Praveen Kumar Bharti & Nitika Nitika

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Contributions

S.N., N.N. contributed to the conceptualization and design of the systematic review. S.N., N.N. led the literature search, data extraction, and analysis, and drafted the initial manuscript. S.N., R.S., N.N. conducted the screening of articles, assessed study quality, and contributed to the synthesis of findings and manuscript revisions. S.N., N.N., P.K.B. critically reviewed the manuscript, and contributed to the final revisions. R.S. assisted with statistical analysis, interpretation of results. All authors approved the final version of the manuscript.

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Correspondence to Nitika Nitika.

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Nema, S., Singhal, R., Bharti, P.K. et al. Malaria in pregnancy and its potential impact on neurodevelopment in children: a systematic review. Pediatr Res (2025). https://doi.org/10.1038/s41390-025-03967-5

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