Malaria is thought to reduce birth weight through a combination of systemic and localized effects. Firstly, malaria may affect birth weight through malaria-induced anemia. Secondly, malaria may reduce birth weight through placental infection (Menendez et al. 2000b). In the latter case, parasites either directly cause a mechanical compromise of placental circulation or indirectly interfere with placental functions and/or induce pathological lesions (Walter et al. 1982).