Elphinstone RE, Weckman AM, McDonald CR, et al. - Through a secondary analysis of a randomized trial of malaria prevention in pregnancy done in Malawi from July 21, 2011, to March 18, 2013, experts evaluated whether malaria infection, particularly early in pregnancy, could remodel significant factors that control placental growth and function and ascertain if these resulted in preterm birth (PTB). In a large cohort of 1,628 Malawian women at risk of malaria infection, levels of ten distinctive angiogenic, inflammatory, and/or metabolic proteins longitudinally during pregnancy were measured and it was exhibited that early infection with malaria was related to alterations in various principal proteins that were significant for healthy pregnancies. The use of ultrasound dating reflected the contribution of early malaria infection to a heightened risk of delivering preterm, formerly thought to transpire originally from malaria late in pregnancy. in conclusion, for the prevention of malaria in pregnancy, prevailing interventions are started at the first antenatal visit, normally in the second trimester. In this study, it was discovered that during their first visit, many women are already malaria-infected. Malaria infection prior to 24 weeks gestation was related to dysregulation of necessary regulators of angiogenesis, metabolism, and inflammation and an amplified risk of PTB. Moreover, in malaria-endemic settings, preventing malaria earlier in pregnancy could decrease placental dysfunction and hence, enhance birth outcomes.