Malaria Prevention with IPTp during Pregnancy Reduces Neonatal Mortality
Open Access
- 26 February 2010
- journal article
- research article
- Published by Public Library of Science (PLoS) in PLOS ONE
- Vol. 5 (2), e9438
- https://doi.org/10.1371/journal.pone.0009438
Abstract
In the global context of a reduction of under-five mortality, neonatal mortality is an increasingly relevant component of this mortality. Malaria in pregnancy may affect neonatal survival, though no strong evidence exists to support this association. In the context of a randomised, placebo-controlled trial of intermittent preventive treatment (IPTp) with sulphadoxine-pyrimethamine (SP) in 1030 Mozambican pregnant women, 997 newborns were followed up until 12 months of age. There were 500 live borns to women who received placebo and 497 to those who received SP. There were 58 infant deaths; 60.4% occurred in children born to women who received placebo and 39.6% to women who received IPTp (p = 0.136). There were 25 neonatal deaths; 72% occurred in the placebo group and 28% in the IPTp group (p = 0.041). Of the 20 deaths that occurred in the first week of life, 75% were babies born to women in the placebo group and 25% to those in the IPTp group (p = 0.039). IPTp reduced neonatal mortality by 61.3% (95% CI 7.4%, 83.8%); p = 0.024]. Malaria prevention with SP in pregnancy can reduce neonatal mortality. Mechanisms associated with increased malaria infection at the end of pregnancy may explain the excess mortality in the malaria less protected group. Alternatively, SP may have reduced the risk of neonatal infections. These findings are of relevance to promote the implementation of IPTp with SP, and provide insights into the understanding of the pathophysiological mechanisms through which maternal malaria affects fetal and neonatal health. ClinicalTrials.gov NCT00209781Keywords
This publication has 29 references indexed in Scilit:
- A Randomized Placebo-Controlled Trial of Intermittent Preventive Treatment in Pregnant Women in the Context of Insecticide Treated Nets Delivered through the Antenatal ClinicPLOS ONE, 2008
- Varying efficacy of intermittent preventive treatment for malaria in infants in two similar trials: public health implicationsMalaria Journal, 2007
- Reducing the burden of malaria in pregnancy by preventive strategiesThe Lancet Infectious Diseases, 2007
- Drugs for preventing malaria in pregnant womenPublished by Wiley ,2006
- A randomized, placebo‐controlled trial of intermittent preventive treatment with sulphadoxine–pyrimethamine in Gambian multigravidaeTropical Medicine & International Health, 2006
- Insecticide-treated nets for preventing malaria in pregnancyEmergencias, 2006
- Implementation of intermittent preventive treatment with sulphadoxine–pyrimethamine for control of malaria in pregnancy in Kisumu, western KenyaTropical Medicine & International Health, 2004
- Chloroquine prophylaxis, iron-folie acid supplementation or case management of malaria attacks in primigravidae in western Uganda: effects on maternal parasitaemia and haemoglobin levels and on birthweightTransactions of the Royal Society of Tropical Medicine and Hygiene, 2000
- The impact of a national impregnated bed net programme on the outcome of pregnancy in primigravidae in The GambiaTransactions of the Royal Society of Tropical Medicine and Hygiene, 1996
- Clinical assessment of gestational age in the newborn infantThe Journal of Pediatrics, 1970