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Published: Monday, February 21, 2011 - 15:30

A combination of Atovaquine and proguanil is used both for treatment and prevention of malaria. Even though it is significantly more expensive than that other preventative anti-malarial Mefloquine (Lariam), some people prefer it because of its theoretical lower side effects profile.

Pregnant women wMalarone in pregnancyho take the anti-malarial atovaquone- proguanil  (more popularly known by its brand name Malarone) during their first trimester might not be increasing their baby's risk of birth defects, a new study suggests.

"Atovaquone- proguanil exposure at any time in weeks 3 through 8 after conception was not significantly associated with increased risk of any major birth defect," write the researchers.

However, lead researcher Dr. Bjorn Pasternak, of Statens Serum Institute in Copenhagen, Denmark, remarked that "We believe it is far too soon to declare this drug to be safe for use in pregnancy."

Published in the February 2011 journal Archives of Internal Medicine, the study is the first to look at pregnant women's use of atovaquone-proguanil (Malarone) and the risk of birth defects.

Researchers looked at data on nearly 571,000 births in Denmark between 2000 and 2008. Overall, 2.5% had a birth defect.

Among the 149 women who used Malarone at some point during the first trimester, slightly more than 1% had a baby with a birth defect.

The findings offer some reassurance that the drug isn't linked to any large risk of birth defects, said Dr. Pasternak. 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, Dr. Pasternak said.

Malarone can be expensive costing up to $200 (£125) for 24 pills.

As for other anti-malarials used for prevention, Dr. Pasternak said the World Health Organization still recommends avoiding mefloquine during the first trimester, despite data on more than 1,000 infants exposed during the first trimester with no evidence of an increased birth defect risk

Source: Medscape

Malarone in pregnancy: No evidence of birth defects

By Dr Joe Kabyemela, MD