Increased demands of pregnancy. Profound hemolysis can aggravate folate deficiency. Anemia due to malaria is more common and severe between 16-29 weeks. It can develop suddenly, in case of severe malaria with high grades of parasitemia. Pre existing iron and folate deficiency can exacerbate the anemia of malaria and vice versa.
Anemia increases perinatal mortality and maternal morbidity and mortality.
It also increases the risk of pulmonary oedema. Risk of post-partum haemorrhage is also higher. Acute pulmonary oedema is also a more common complication of malaria in pregnancy compared to the non-pregnant population. It may be the presenting feature or can develop suddenly after several days. It is more common in 2 nd and 3 rd trimesters.