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Is Artemisinin safe in pregnancy ?

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Dr Pete Njoku, MD, FRCS, FRSM Eng.


   In sub-sahara Africa, malaria is a killer disease in pregnant  women and responsible for a large percentage of the deaths in pregnancy.

Chloroquine was originally the drug of choice for the treatment of malaria during pregnancy decades ago. It is nolonger prescribed because of resistance to the drug by the malaria parasite.

The WHO has shown that Artemisinin is less resistant to malaria unlike old chloroquine. It therefore wants all countries with proven malaria resistance to switch to Artemisinin-based ACT.

Artemisinin is derived from Artemisia annua L. (A. annua), commonly called annual wormwood, and belonging to the family Asteraceae, is a medicinal plant native to temperate Asia esppecially China but has presently naturalized throughout the world. It has been recently introduced for commercial cultivation in Nigeria. 

The plant has been scientifically revealed to contain a rich portfolio of bioactive compounds including polyphenols and exhibits a wide range of pharmacological properties including antimalarial, antimicrobial, anti-parasitic, and antiviral activities.

A large Welcome Trust and Bill and Melinda Gates foundation, funded study just published in the Lancet has found Artemisinin is safe in the first trimester and therefore throughout pregnancy. It has no significant adverse effects on the unborn baby. 

Malaria in pregnancy can be complicated by a miscarriage. This is therefore welcome news.

The British medical journal, the Lancet concludes;

"First-trimester falciparum and vivax malaria both increase the risk of miscarriage. We noted no evidence of an increased risk of miscarriage or of major congenital malformations associated with first-line treatment with an artemisinin derivative compared with quinine".

"In view of the low efficacy of quinine and wide availability of highly effective artemisinin-based combination therapies, it is time to reconsider first-trimester antimalarial treatment recommendations".

The first trimester, which is the first three months of pregnancy is a very sensitive time. It is the period when most of the baby's organs are developing. In order to prevent organ malformation most drugs are best avoided during this period. This is therefore great news.

If you have laboratory confirmed Malaria fever during pregnancy, your doctor can now safely prescribe Atermisinin combination therapy, ACT.

This Welcome Trust / Gates foundation study further elevates the general safety profile of this wonder traditional Chinese herbal drug Artemisinin.

This is great news for pregnant mothers diagnosed with malaria. 


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