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Int J Gynaecol Obstet. 2013 May;121(2):103-9. doi: 10.1016/j.ijgo.2012.12.014. Epub 2013 Mar 13.

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

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1
Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, USA. mcclure@rti.org

Abstract

BACKGROUND:

Malaria in pregnancy is a significant contributor to adverse pregnancy outcome, especially in Sub-Saharan Africa. Prevention with sulfadoxine/pyrimethamine (SP) during pregnancy has been recommended in malaria-endemic areas but concerns remain about its benefit.

OBJECTIVES:

To evaluate the association between recommended preventative SP programs in pregnancy and low birth weight (LBW) and maternal anemia through available clinical trial, observational, and programmatic evaluation studies.

SEARCH STRATEGY:

Systematic review of published studies on malaria in pregnancy and pregnancy outcomes.

SELECTION CRITERIA:

Clinical studies from Sub-Saharan Africa from the past 10 years were included.

DATA COLLECTION AND ANALYSIS:

English articles published since 2002 and listed in PubMed were identified using defined keywords, and their source documents were reviewed. Thirty-three studies involving malaria in pregnancy that recorded treatment rates and birth outcomes were included.

MAIN RESULTS:

SP use among primigravidae was consistently associated with decreased LBW and anemia rates in clinical trials. Effects were less consistent in observational studies.

CONCLUSIONS:

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.

PMID:
23490427
DOI:
10.1016/j.ijgo.2012.12.014
[Indexed for MEDLINE]
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