ABSTRACT
So long as Woman has walked the earth, malaria may have stalked her. The earliest human records describe the periodic fevers that characterize malaria, and these fevers in pregnant women were known to carry the risk of maternal or fetal death. Hippocrates encountered such cases, and the 16th-century Spanish physician Mercado recommended blood-letting to prevent deterioration in the mother’s condition. In the 1700s, Torti and his Italian contemporaries treated pregnancy malaria with cinchona bark (quinine), a new tool that facilitated both treatment and diagnosis. Quinine could prevent the worst consequences of pregnancy malaria, but Góth in 1881, and Chiarleoni in 1886, determined that babies brought to term from infected women still suffered in the form of low birthweight. Laveran’s discovery of the malaria parasite in 1880 opened new vistas for inquiry. Around 1900, Bignami and Sereni found that P. falciparum multiplied to great density in the placenta, and in 1915, Clark in Panama observed that indigenous women could carry heavy placental parasitemias asymptomatically. In 1938, Garnham detailed the pattern by which women acquire immunity to pregnancy malaria, and 20 years later, Cannon first asserted that semi-immune women were most susceptible to parasitemia during their first pregnancy. Many of the great historical figures of malariology drew special attention to pregnancy malaria, and amassed a body of knowledge that underpins our current understanding of its epidemiology and pathogenesis.
