Date: November 2017, Version 3

What is it?

Quinine is sometimes taken in combination with another medicine to treat a person who is infected with malaria. Quinine is also occasionally used to treat leg cramps.

Malaria and pregnancy
Malaria is a serious illness that is spread by mosquito bites and can result in death. Malaria infection in pregnancy can be dangerous to the health of both mother and baby. Pregnant women are therefore advised to avoid travelling to areas where there is a risk of catching malaria.

If you are pregnant or planning a pregnancy and cannot avoid travelling to a high risk malaria area, ask your doctor for advice as soon as possible as you will need to take another antimalarial medicine (not quinine) for a few weeks before you travel to prevent malaria infection.

No antimalarial medicine is 100% effective. It is therefore very important that you also reduce the chance of being bitten by using insect repellents, mosquito nets, and covering as much skin as possible with clothing, particularly between dusk and dawn. Please read our bumps leaflet on insect repellents for more information on which products are advised for use in pregnancy.

Is it safe to take quinine in pregnancy?

You should not avoid taking quinine because you are pregnant. The risk of harm to you and your baby from malaria is likely to be far greater than any possible risk from taking quinine. There is no convincing scientific evidence that quinine is harmful to an unborn baby. However, if you are using quinine to treat leg cramps it is likely that your doctor may recommend that you stop treatment until after your baby is born.

What if I have already taken quinine during pregnancy?

It is always a good idea to let your doctor know that you are pregnant if you have taken any medicines in case you need any additional monitoring or treatment.

Can taking quinine in pregnancy cause miscarriage?

Malaria itself increases the chance of miscarriage which can make the interpretation of study results difficult, but overall, the results from seven studies are reassuring. In the past, quinine was used as a ‘folk remedy’ to induce miscarriage, although it is now thought to be ineffective for this purpose.

Can taking quinine in pregnancy cause my baby to be born with birth defects?

A baby’s body and most internal organs are formed during the first 12 weeks of pregnancy. It is mainly during this time that some medicines are known to cause birth defects.

No evidence of a link between taking quinine in early pregnancy and having a baby with a birth defect was provided by any of the seven studies carried out so far, that investigated a total of around 1,000 women.

Can taking quinine in pregnancy cause preterm birth or my baby to be small at birth (low birth weight)?

Quinine use in pregnancy has not been shown to cause a baby to be born early (before 37 weeks of pregnancy) or to have a low birth weight (<2,500g). Seven studies have investigated the chance of preterm birth and six the chance of low birth weight. All have agreed that there are no links.  

Can taking quinine in pregnancy cause stillbirth?

There is no scientific proof from a total of fifteen studies that taking quinine during pregnancy increases the chance of stillbirth. Malaria itself increases the chance of stillbirth which can make interpretation of these study results difficult, but overall, the results are reassuring.

Can taking quinine in pregnancy cause learning or behavioural problems in the child?

A baby’s brain continues to develop right up until the end of pregnancy. It is therefore possible that taking certain medicines at any stage of pregnancy could have a lasting effect on a child’s learning or behaviour.

Five studies have shown no difference in eyesight, hearing and developmental milestones of babies who were exposed to quinine while in the womb compared to babies not exposed in the womb. However, in these studies, the babies were examined at a maximum of one year of age, so we do not know if any differences became apparent as the children got older.

Will my baby need extra monitoring during pregnancy?

As part of their routine antenatal care, most women will be offered a scan at around 20 weeks of pregnancy to look for birth defects and to check the baby’s growth.

Taking quinine during pregnancy is not expected to cause any problems that would require extra monitoring of your baby. However, if you have been infected with malaria during your pregnancy it is likely that your doctor will wish to monitor your pregnancy more closely, to ensure that the baby is growing and developing as expected. 

A side effect of treatment with quinine can be lowered blood sugar. Your doctor may therefore wish to closely monitor your blood sugar levels if you are treated with quinine during pregnancy.

Are there any risks to my baby if the father has taken quinine?

We would not expect any increased risk to your baby if its father took quinine before or around the time your baby was conceived.

Who can I talk to if I have questions?

If you have any questions regarding the information in this leaflet please discuss them with your health care provider. They can access more detailed medical and scientific information from www.uktis.org.  

How can I help to improve drug safety information for pregnant women in the future?

Our online reporting system (MyBump Portal) allows women who are currently pregnant to create a secure record of their pregnancy, collected through a series of questionnaires. You will be asked to enter information about your health, whether or not you take any medicines, your pregnancy outcome and your child's development. You can update your details at any time during pregnancy or afterwards. This information will help us better understand how medicines affect the health of pregnant women and their babies. Please visit the MyBump Portal to register.

General information
Sadly, miscarriage and birth defects can occur in any pregnancy.

Miscarriage occurs in about 1 in every 5 pregnancies, and 1 in every 40 babies are born with a birth defect. This is called the ‘background risk’ and happens whether medication is taken or not.

Most medicines cross the placenta and reach the baby. For many medications this is not a problem. However, some medicines can affect a baby’s growth and development.

If you take regular medication and are planning to conceive, you should discuss whether your medicine is safe to continue with your doctor/health care team before becoming pregnant. If you have an unplanned pregnancy while taking a medicine, you should tell your doctor as soon as possible.

If a new medicine is suggested for you during pregnancy, please make sure that the person prescribing it knows that you are pregnant. If you have any concerns about a medicine, you can check with your doctor, midwife or pharmacist.

Our Bumps information leaflets provide information about the effects of medicines in pregnancy so that you can decide, together with your healthcare provider, what is best for you and your baby.