Antibody to P. falciparum in Pregnancy Varies with Intermittent Preventive Treatment Regime and Bed Net Use

BACKGROUND Antibodies towards placental-binding P. falciparum are thought to protect against pregnancy malaria; however, environmental factors may affect antibody development. METHODS AND FINDINGS Using plasma from pregnant Malawian women, we measured IgG against placental-binding P. falciparum parasites by flow cytometry, and related results to intermittent preventive treatment (IPTp) regime, and bed net use. Bed net use was associated with decreased antibody levels at mid-pregnancy but not at 1 month post partum (1 mpp). At 1 mpp a more intensive IPTp regime was associated with decreased antibody levels in primigravidae, but not multigravidae. CONCLUSIONS/SIGNIFICANCE Results suggest bed nets and IPTp regime influence acquisition of pregnancy-specific P. falciparum immunity.