The Antimalarial Mefloquine during Pregnancy and its Effects on Infants' Health and Growth

A study performed by ISGlobal researchers, in collaboration with the Manhiça Health Research Centre (CISM) and other African and European research centres, shows that the mortality, morbidity and development during the first year of life is not affected by intermittent preventive treatment with mefloquine. The study, published in PLOS Medicine and led by Dr. Clara Menendez, is one of the first to assess the drug’s impact on the health of the infants, at such a large scale.

There is little available information on the health of infants born to mothers that received mefloquine (MQ) treatment during their pregnancy. Based on a previous clinical assay that compared the efficacy and safety of intermittent preventive treatment with MQ versus sulfadoxine-pyrimethamine (SP) in pregnant women from four countries in Sub-Saharan Africa (Benin, Gabon, Mozambique and Tanzania), the authors followed up the babies of these women during one year, in order to evaluate the long-term effect of the treatment on the infant’s health. They compared the mortality, morbidity, growth and psychomotor development of more than 2.800 infants born to women that received MQ and 1.400 infants born to women that received SP during pregnancy. They found no differences in mortality, morbidity or growth between both groups. Although the MQ group showed a delay in 3 out of 13 criteria of psychomotor development at month 9, this effect was not confirmed in later visits. However, as the first author of the study, Dr. María Rupérez, points out, “even though we believe that these differences are casual or due to multiple testing, we cannot rule out an effect of MQ. Thus, we conclude that further investigation is required to determine whether such association exists”.   

The findings described in the study are important, since MQ is the recommended drug for malaria prevention in pregnant women traveling to countries affected by malaria, and it is also recommended for the treatment of malaria episodes during pregnancy, in combination with other drugs.  

Reference:

María Rupérez, Raquel González, Ghyslain Mombo-Ngoma, et al. Mortality, Morbidity, and Developmental Outcomes in Infants Born to Women Who Received Either Mefloquine or Sulfadoxine-Pyrimethamine as Intermittent Preventive Treatment of Malaria in Pregnancy: A Cohort Study. PLOS Medicine, 2016; 13 (2): e1001964