Unger H.W.Acharya S.Arnold L.Wu C.van Eijk A.M.Gore-Langton G.R.ter Kuile F.O.Lufele E.Chico R.M.Price R.N.Moore B.R.Thriemer K.Rogerson S.J.Mahidol University2023-10-242023-10-242023-11-01The Lancet Global Health Vol.11 No.11 (2023) , e1805-e1818https://repository.li.mahidol.ac.th/handle/123456789/90715Half of all pregnancies at risk of malaria worldwide occur in the Asia–Pacific region, where Plasmodium falciparum and Plasmodium vivax co-exist. Despite substantial reductions in transmission, malaria remains an important cause of adverse health outcomes for mothers and offspring, including pre-eclampsia. Malaria transmission is heterogeneous, and infections are commonly subpatent and asymptomatic. High-grade antimalarial resistance poses a formidable challenge to malaria control in pregnancy in the region. Intermittent preventive treatment in pregnancy reduces infection risk in meso-endemic New Guinea, whereas screen-and-treat strategies will require more sensitive point-of-care tests to control malaria in pregnancy. In the first trimester, artemether–lumefantrine is approved, and safety data are accumulating for other artemisinin-based combinations. Safety of novel antimalarials to treat artemisinin-resistant P falciparum during pregnancy, and of 8-aminoquinolines during lactation, needs to be established. A more systematic approach to the prevention of malaria in pregnancy in the Asia–Pacific is required.MedicineReviewSCOPUS10.1016/S2214-109X(23)00415-12-s2.0-851741614782214109X