Maternal health experts have stated that fever during pregnancy is abnormal and poses the risk of miscarriage, premature delivery and birth defects.
They explained that fever, which is defined as a body temperature higher than 37.5°C, often indicates underlying infections such as malaria, urinary tract infection or pneumonia, stressing that if left untreated, it could lead to congenital malformations and fetal deaths, among other complications.
The gynaecologists further noted that although pregnancy hormones may slightly increase a woman's body temperature, any rise in body temperature should not be ignored but promptly reported to the hospital.
They stressed that malaria was the commonest cause of fever in pregnancy and advised pregnant women to prevent exposure to mosquitoes and register early for antenatal care in accredited health facilities.
The World Health Organisation states that malaria in pregnancy is responsible for an estimated 10,000 maternal deaths and 200,000 neonatal deaths annually.
According to the Malaria Consortium, malaria in pregnancy is a serious public health issue, and in 2018, about 11 million pregnant women living in sub-Saharan Africa were infected with malaria, with nearly 900,000 children born with a low birth weight due to malaria in pregnancy.
In Nigeria, malaria is responsible for about 11 per cent of maternal deaths, accounting for a significant portion of global malaria deaths.
To prevent malaria in pregnancy, the WHO recommends the Intermittent Preventive Treatment in Pregnancy with sulfadoxine-pyrimethamine, vector control using insecticide-treated bed nets and repellents, and chemoprophylaxis for travel to risk areas, with mefloquine often recommended for the second half of pregnancy.
Commenting on the matter, a professor of Obstetrics and Gynaecology at the Obafemi Awolowo University, Ile-Ife, Osun State, Ernest Orji, warned that fever during pregnancy is abnormal and could indicate underlying infections such as malaria, urinary tract infection, or pneumonia.
Orji explained that although the pregnancy hormone, progesterone, slightly raises a woman's body temperature, "that is not fever per se."
He explained that the commonest cause of fever in pregnancy in Nigeria is malaria, stating that when it occurs, it can be dangerous and can cause premature birth.
The don listed other possible causes of fever in pregnancy to include urinary tract infections, pneumonia, hepatitis, and viral illnesses, adding that fever in expectant mothers should never be ignored.
"When a pregnant woman presents with fever, we first test for malaria parasites in the blood and check the urine for infection. Malaria and urinary infections are the most common causes, though they can sometimes coexist," he said.
Orji noted that the symptoms of fever include a body temperature higher than 37.2°C, headache, nausea, vomiting, painful urination, abdominal pain, and sometimes contractions.
He also warned that untreated fever could result in anaemia and malnutrition in the mother, as nausea and vomiting often make it difficult for pregnant women to retain food.
"These symptoms may worsen at night or in the evening. In severe cases, the fever can lead to miscarriage, preterm delivery, or poor growth of the baby. The baby can even be born with malaria if the parasite crosses the placenta," he said.
On treatment, the gynaecologist advised that pregnant women with fever should not self-medicate.
"The first thing is to identify and treat the cause of the fever. If it is malaria, we treat based on the test result. We also give paracetamol to control the fever and, in severe cases, admit the patient for intravenous treatment.
"We also treat other identified infections and check the blood level to know whether there is anaemia. But, the first thing is to find the cause of the fever and then treat," the don said.
For prevention, Orji emphasised the importance of routine malaria prophylaxis in pregnancy.
"That is why we give pregnant women intermittent preventive treatment using sulfadoxine-pyrimethamine at least three times during pregnancy," he said.
He warned that malaria at any stage of pregnancy could be fatal if severe, but noted that infection in early pregnancy is more dangerous.
"When malaria occurs in the first trimester, it can affect the early growth of the baby and cause miscarriage. In later stages, it can lead to low birth weight or preterm delivery," Orji said.
He stressed that the severity of the infection determines how fatal it can be, urging pregnant women to seek prompt medical attention when they experience fever rather than assuming it is normal.
Also, a professor of Obstetrics and Gynaecology at the Delta State University, Abraka, Lawrence Omo-Aghoja, cautioned pregnant women against taking fever lightly, warning that untreated high temperature during pregnancy could cause congenital malformations, miscarriages, or even foetal death.
He explained that fever, defined as a body temperature higher than 37.5°C, often signals that "something has gone wrong in the body."
He said, "Fever in pregnancy is not normal. It means there's an underlying issue, and in our environment, the most common cause is malaria, closely followed by bacterial infections. And that's why you find that because malaria is so common, it's endemic in our environment, and causes significant challenges when they do occur."
The gynaecologist said malaria remains endemic in Nigeria and accounts for a significant proportion of fever cases among pregnant women.
"To prevent malaria, we give pregnant women prophylactic antimalarial drugs and encourage the use of insecticide-treated nets, window nets, and fumigation to reduce mosquito breeding. Once malaria is prevented, the incidence of fever in pregnancy will drop," he added.
Omo-Aghoja also listed other causes of fever during pregnancy to include respiratory tract infections such as pneumonia, urinary tract infections, viral diseases like rubella, influenza, and measles, as well as appendicitis and inflammatory bowel disease.
He warned that the consequences of untreated fever could be severe for mother and baby.
"In early pregnancy, especially within the first eight weeks when the baby's organs are forming, high fever can cause congenital malformations such as heart defects and neural tube defects affecting the spine and brain," he explained.
The researcher on Infertility and Reproductive Endocrinology noted that sustained or recurrent fever could cause miscarriage, premature labour, and restricted foetal growth, leading to low birth weight or foetal distress.
"If the condition is not treated on time, it may even lead to foetal death," he cautioned.
The professor advised pregnant women to seek prompt medical attention whenever they notice elevated body temperature, rather than resort to self-medication.
He said, "Good antenatal care and early booking are key. Once a pregnant woman presents with fever, a proper diagnosis must be made to identify the cause, and proper, adequate, and efficient treatment must be executed immediately. This will protect both mother and baby."