Submicroscopic Malaria Infections During Pregnancy: Impacts on Maternal Haematological Parameters and Adverse Foetal Outcomes in Rural Nigeria

Malaria during pregnancy remains a significant public health challenge in Nigeria, particularly in rural areas where access to quality healthcare services, including advanced diagnostic facilities, is limited. Traditional diagnostic methods such as microscopy and rapid diagnostic tests are commonly used; however, they do not always detect submicroscopic malaria infections, leading to an underestimation of the true disease burden. This study presents a literature review of the prevalence of submicroscopic malaria infections, their impact on maternal haematological parameters, and their relationship with adverse foetal outcomes in rural areas of Nigeria and similar resource-limited settings.
A narrative review design with a systematic search strategy was employed. Relevant studies published between 2005 and 2025 were retrieved from PubMed, Scopus, Web of Science, Google Scholar, and African Journals Online. Data were extracted, synthesised, and organised under the themes of prevalence, maternal haematological outcomes, and foetal health outcomes.
The review indicated that submicroscopic malaria infections account for a significant proportion of malaria cases during pregnancy. The prevalence of these infections was found to be associated with the diagnostic method used, the intensity of malaria transmission, and the extent of coverage of malaria preventive interventions. The association between submicroscopic infections and maternal anaemia, low haemoglobin levels, and reduced packed cell volume was consistently reported. Furthermore, these infections were linked to adverse foetal outcomes, including low birth weight, preterm delivery, and intrauterine growth restriction (IUGR). These risks were further exacerbated by inadequate diagnostic facilities and limited coverage of preventive services in rural areas.
The study concludes that submicroscopic malaria infections are a clinically significant yet often overlooked contributor to maternal and neonatal morbidity in rural Nigeria. Strengthening diagnostic capacity, improving preventive interventions, and enhancing antenatal care services are essential to reducing their impact on maternal and child health outcomes.

Submicroscopic malaria, pregnancy, maternal anaemia

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