Malaria susceptibility is increased during pregnancy. In semi-immune women, lifelong exposure to P. falciparum parasites has induced immunity that controls infection with common parasite phenotypes, such as parasites expressing PfEMP1 variants. that bind to CD36 on the endothelium of the peripheral vasculature. Therefore, the total biomass of the parasite may be low and difficult to diagnose with standard tools such as blood smear microscopy, even in the presence of significant placental infection. Furthermore, in the placenta, infected erythrocytes (IE) express the VAR2CSA variant of PfEMP1 to bind chondroitin sulfate A (CSA) but not other common endothelial receptors such as CD36 or ICAM-1. New mothers lack immunity to CSA-binding parasites and are highly susceptible to parasitaemia and chronic infections, making this group an important reservoir of infection in the community. During s...