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No birth defect risk seen with malaria drug

Pregnant women who take the anti-malarial drug Malarone (known generically as atovaquone-proguanil) during their first trimester might not be increasing their baby's risk of birth defects.

No birth defect risk seen with malaria drug

Pregnant women who take the anti-malarial drug Malarone (known generically as atovaquone-proguanil) during their first trimester might not be increasing their baby's risk of birth defects.

Caused by a mosquito-borne parasite, malaria is widespread in large areas of Africa, Asia and South and Central America, where it kills about 1 million people a year. An estimated 10,000 to 30,000 travelers develop malaria every year, and about 150 die.

Most anti-malaria drugs, including this one, are not approved for use in pregnancy. So when pregnant women want to travel to malaria-ridden regions, they face a huge problem: should they take preventive medicines that haven't been proven safe for the fetus? In general, experts advise all pregnant women to avoid traveling to countries where malaria is common, since the infection itself may be dangerous to the mother and fetus. The cheapest and mostly widely used anti-malaria drug, called chloroquine, is considered safe during pregnancy. But resistance to that drug has become common worldwide. Another anti-malaria drug, the antibiotic doxycycline, is known to have adverse effects on the foetus.

Researchers looked at data on nearly 571,000 births in Denmark between 2000 and 2008. Overall, 2 to 3 out of every 100 newborns had a birth defect. Among the 149 women who used Malarone at some point during the first trimester, roughly one of every hundred had a baby with a birth defect. The findings offer some reassurance that the drug is not linked to any large risk of birth defects.

The above study is the first to look at pregnant women's use anti-malaria drug and the risk of birth defects. Still, since only a small number of women in the study took Malarone during early pregnancy, the findings cannot rule out the possibility of some risk, the researchers say, and it is too soon to declare the drug safe for pregnant women who might need to take it.

Experts recommend pregnant women traveling to malaria-endemic countries consult a doctor experienced in travel medicine. That way, they can learn about the pros and cons of traveling altogether, the details of malaria in the region they are visiting, and their options for anti-malaria medication.
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