A systematic review of the impact of malaria prevention in pregnancy on low birth weight and maternal anemia

McClure, Elizabeth M; Goldenberg, Robert L.; Dent, Arlene E.; Meshnick, Steven R.

doi:10.1016/j.ijgo.2012.12.014

Cited by 64 publications

(56 citation statements)

References 38 publications

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“…Due to the adverse effects of malaria infection in pregnancy, recommendations have been made to use insecticide treated mosquito nets and prophylactic drugs such as sulfadoxine pyrimethamine. The use of these measures have brought reductions in anaemia and low birth weight delivery in pregnant women [28, 29]. There were some limitations to this study.…”

Section: Discussionmentioning

confidence: 99%

Anaemia in pregnant adolescent girls with malaria and practicing pica

Intiful¹,

Wiredu²,

Asare³

et al. 2016

Pan Afr Med J

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IntroductionPregnancy during the adolescent period is challenging mainly because of the nutritional demands of both the adolescent and pregnancy period. The risk for anaemia increases especially in developing countries such as Ghana where malaria is endemic and the practice of pica is common. In this study, we sought to determine the prevalence of anaemia, pica practice and malaria infection among pregnant adolescent girls and assess the extent to which these factors are associated.MethodsTwo hundred and sixty five (265) pregnant adolescent girls were recruited from three hospitals in Accra. Haemoglobin levels, malaria infection and the practice of pica were assessed. Pearson's Chi squared tests were used to determine associations and logistic regression analysis was used to determine the odds of being anaemic. Significance was set at p≤0.05.ResultsAnaemia prevalence was 76% with severity ranging from mild (47.8%) to severe (0.8%). About 27.5% were moderately anaemic. Pica was practiced in only 9.1% of the girls. Malaria infection was prevalent in 17.7% of the girls. The logistic regression analysis indicated that pregnant girls with malaria infection were 3.56 times more likely to be anaemic when compared to those without malaria. Also, those who practiced pica were 1.23 times more likely to be anaemic when compared to those who did not practice pica.ConclusionAnaemia is very prevalent in pregnant adolescent girls and is a public health problem. Drastic measures should be taken to reduce the high prevalence.

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Section: Discussionmentioning

confidence: 99%

Anaemia in pregnant adolescent girls with malaria and practicing pica

Intiful¹,

Wiredu²,

Asare³

et al. 2016

Pan Afr Med J

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“…Recent studies however reported a significant decline in prevalence following PAM control interventions. The protection of joint ITNs with IPTp-SP use is significant in only certain trials, yet reported ITN use ranges from 5 to 25%, and this might not be sufficient enough to show an effect [60]. An article reviewed the influence of preventive measures on PAM during a decade, effectively 2002 to 2012, and reported placental malaria rates ranging from 2 to 29% among women treated with less than three doses (mainly two) of sulphadoxine-pyrimethamine (SP) compared to 2 to 8% among women receiving more than or equal three doses (mainly three) [60].…”

Section: Methods: Search Strategy and Selection Criteriamentioning

confidence: 99%

“…The protection of joint ITNs with IPTp-SP use is significant in only certain trials, yet reported ITN use ranges from 5 to 25%, and this might not be sufficient enough to show an effect [60]. An article reviewed the influence of preventive measures on PAM during a decade, effectively 2002 to 2012, and reported placental malaria rates ranging from 2 to 29% among women treated with less than three doses (mainly two) of sulphadoxine-pyrimethamine (SP) compared to 2 to 8% among women receiving more than or equal three doses (mainly three) [60]. A novel study included within the afore mentioned review describes a two-fold lower prevalence of placental malaria in the three-dose SP group compared to the two-dose SP group (adjusted prevalence ratio = 0.48) [61].…”

Section: Methods: Search Strategy and Selection Criteriamentioning

confidence: 99%

“…A novel study included within the afore mentioned review describes a two-fold lower prevalence of placental malaria in the three-dose SP group compared to the two-dose SP group (adjusted prevalence ratio = 0.48) [61]. Even if the augmented efficacy associated with higher doses is predominately observed in clinical trials rather than in studies of public health programme implementations [60], the emergence of SP resistance is certainly shaping the efficacy of IPTp, and consequently its influence on the malaria burden in infants.…”

Section: Methods: Search Strategy and Selection Criteriamentioning

confidence: 99%

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Pregnancy-associated malaria and malaria in infants: an old problem with present consequences

Moya-Alvarez

Abellana

Cot

2014

Malar J

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Albeit pregnancy-associated malaria (PAM) poses a potential risk for over 125 million women each year, an accurate review assessing the impact on malaria in infants has yet to be conducted. In addition to an effect on low birth weight (LBW) and prematurity, PAM determines foetal exposure to Plasmodium falciparum in utero and is correlated to congenital malaria and early development of clinical episodes during infancy. This interaction plausibly results from an ongoing immune tolerance process to antigens in utero, however, a complete explanation of this immune process remains a question for further research, as does the precise role of protective maternal antibodies. Preventive interventions against PAM modify foetal exposure to P. falciparum in utero, and have thus an effect on perinatal malaria outcomes. Effective intermittent preventive treatment in pregnancy (IPTp) diminishes placental malaria (PM) and its subsequent malaria-associated morbidity. However, emerging resistance to sulphadoxine-pyrimethamine (SP) is currently hindering the efficacy of IPTp regimes and the efficacy of alternative strategies, such as intermittent screening and treatment (IST), has not been accurately evaluated in different transmission settings. Due to the increased risk of clinical malaria for offspring of malaria infected mothers, PAM preventive interventions should ideally start during the preconceptual period. Innovative research examining the effect of PAM on the neurocognitive development of the infant, as well as examining the potential influence of HLA-G polymorphisms on malaria symptoms, is urged to contribute to a better understanding of PAM and infant health.

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“…Although guidelines recommend that HIV-positive women who are pregnant receive CTX without SP, real-world application of HIV and malaria guidelines in pregnancy suggests that HIV-positive women are receiving both ART and SP, with or without CTX. 15 SP has been associated with a decreased risk of low birth weight (LBW) among pregnant women in general [16][17][18] and among HIV-infected pregnant women in specific. 19 A Cochrane review of trials comparing dosing regimens found that infants born to HIV-positive pregnant women receiving three or more doses of SP weighed more than those born to mothers receiving two doses.…”

Section: Introductionmentioning

confidence: 99%

Dosage of Sulfadoxine–Pyrimethamine and Risk of Low Birth Weight in a Cohort of Zambian Pregnant Women in a Low Malaria Prevalence Region

Stoner

Vwalika

Smid

et al. 2017

The American Society of Tropical Medicine and Hygiene

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Abstract. In Lusaka, Zambia, where malaria prevalence is low, national guidelines continue to recommend that all pregnant women receive sulfadoxine-pyrimethamine (SP) for malaria prophylaxis monthly at every scheduled antenatal care visit after 16 weeks of gestation. Human immunodeficiency virus (HIV)-positive women should receive co-trimoxazole prophylaxis for HIV and not SP, but many still receive SP. We sought to determine whether increased dosage of SP is still associated with a reduced risk of low birth weight (LBW) in an area where malaria transmission is low. Our secondary objective was to determine whether any association between SP and LBW is modified by receipt of antiretroviral therapy (ART). We analyzed data routinely collected from a cohort of HIV-positive pregnant women with singleton births in Lusaka, Zambia, between February 2006 and December 2012. We used a logPoisson model to estimate the risk of LBW by dosage of SP and to determine whether the association between SP and LBW varied by receipt of ART. Risk of LBW declined as the number of doses increased and appeared lowest among women who received three doses (adjusted risk ratio [ARR] = 0.78; 95% confidence interval [CI] = 0.64-0.95). In addition, women receiving combination ART had a higher risk of delivering an LBW infant compared with women receiving no treatment or prophylaxis (ARR = 1.18; 95% CI = 1.09-1.28), but this risk was attenuated among women who were receiving SP (risk ratio = 1.09; 95% CI = 0.99-1.21). SP was associated with a reduced risk of LBW in HIVpositive women, including those receiving ART, in a low malaria prevalence region.

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A systematic review of the impact of malaria prevention in pregnancy on low birth weight and maternal anemia

Abstract: Although randomized trials have demonstrated the efficacy of SP, studies evaluating scale-up programs found less consistent reductions in LBW and maternal anemia. Additional strategies to improve SP coverage may reduce the LBW and maternal anemia associated with malaria in pregnancy.

Cited by 64 publications

References 38 publications

Anaemia in pregnant adolescent girls with malaria and practicing pica

Anaemia in pregnant adolescent girls with malaria and practicing pica

Pregnancy-associated malaria and malaria in infants: an old problem with present consequences

Dosage of Sulfadoxine–Pyrimethamine and Risk of Low Birth Weight in a Cohort of Zambian Pregnant Women in a Low Malaria Prevalence Region

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