Pregnancy and mefloquine prevention of malaria

(1) Mefloquine is teratogenic in animals at high doses. (2) A prospective cohort study of several hundred women exposed to mefloquine at prophylactic doses (250 mg per week) in early pregnancy showed no increased risk of malformations. (3) Exposure to mefloquine in early pregnancy is not an indication for termination. (4) Data on exposure during the second or third trimester are reassuring. According to the World Health Organisation (WHO), the risk-benefit ratio of mefloquine prophylaxis is favourable in pregnant women from the fourth month of pregnancy onwards in areas of group III chemoresistance. (5) In France, mefloquine is contraindicated throughout pregnancy. In other countries mefloquine is approved from the first trimester to cover unavoidable visits to areas of group III chemoresistance.