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Malaria and immunity during pregnancy and postpartum: a tale of two species

机译：怀孕和产后的疟疾和免疫力：两个物种的故事

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摘要

It is well established that pregnant women are at an increased risk of Plasmodium falciparum infection when compared to non-pregnant individuals and limited epidemiological data suggest Plasmodium vivax risk also increases with pregnancy. The risk of P. falciparum declines with successive pregnancies due to the acquisition of immunity to pregnancy-specific P. falciparum variants. However, despite similar declines in P. vivax risk with successive pregnancies, there is a paucity of evidence P. vivax-specific immunity. Cross-species immunity, as well as immunological and physiological changes that occur during pregnancy may influence the susceptibility to both P. vivax and P. falciparum. The period following delivery, the postpartum period, is relatively understudied and available epidemiological data suggests that it may also be a period of increased risk of infection to Plasmodium spp. Here we review the literature and directly compare and contrast the epidemiology, clinical pathogenesis and immunological features of P. vivax and P. falciparum in pregnancy, with a particular focus on studies performed in areas co-endemic for both species. Furthermore, we review the intriguing epidemiology literature of both P. falciparum and P. vivax postpartum and relate observations to the growing literature pertaining to malaria immunology in the postpartum period.
机译：公认的是，与未怀孕的人相比，孕妇的恶性疟原虫感染的风险增加，流行病学数据有限，表明间质疟原虫的风险也随着怀孕而增加。由于获得了针对妊娠特定恶性疟原虫变异体的免疫力，恶性疟原虫的风险随着连续怀孕而降低。然而，尽管间日疟原虫的风险随着连续怀孕而下降了类似的趋势，但缺乏证据显示间日疟原虫特异性免疫。跨物种免疫以及怀孕期间发生的免疫和生理变化可能会影响间日疟原虫和恶性疟原虫的易感性。分娩后的时期，即产后时期，被相对研究不足，现有的流行病学数据表明，这也可能是疟原虫属感染风险增加的时期。在这里，我们审查文献，并直接比较和对比妊娠间日疟和恶性疟原虫的流行病学，临床发病机制和免疫学特征，特别着重于在这两个物种共流行的地区进行的研究。此外，我们回顾了恶性疟原虫和间日疟原虫产后的有趣的流行病学文献，并将观察结果与在产后时期与疟疾免疫学有关的日益增长的文献相关联。

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