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Trends in pregnancy outcomes in Malawian adolescents receiving antimalarial and hematinic supplements

Msyamboza, Kelias, Savage, E.J., Kalanda, Gertrude, Kazembe, Peter, Gies, Sabine, D'Alessandro, Umberto and Brabin, Bernard (2010) 'Trends in pregnancy outcomes in Malawian adolescents receiving antimalarial and hematinic supplements'. Acta Obstetricia et Gynecologica Scandinavica, Issue 89(8), pp. 1011-1016.

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Abstract

Abstract Objective. To describe pregnancy outcomes of adolescent and adult primigravidae receiving antimalarials and hematinic supplementation and compare findings with a survey in this area a decade earlier. Design. Cross-sectional surveys in intervention and control sites. Setting. Community, antenatal and delivery facilities in Chikwawa, Malawi. A rural area with year round malaria transmission. Methods. Data on antenatal attendance, uptake of intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP), birthweight, malaria, anaemia, for 2,152 primigravidae. Outcome measures. Place of delivery, anaemia, malaria, birthweight. Results. Fewer adolescent than adult primigravidae received >/=2 IPTp-SP doses (66 vs. 77.2%, p < 0.001), although more attended for two or more antenatal visits (92.0 vs. 76.7%, p < 0.001). Only 24.1% of adolescent primigravidae attended for hospital delivery. Women resident in intervention sites receiving IPTp-SP community distribution were more likely to choose a community delivery (p < 0.01), and have higher uptake of IPTp-SP (p = 0.036) than women not resident in these villages. Postnatal malaria prevalence was low and did not differ by age or place of delivery. Postnatal anaemia and low birthweight prevalence were higher in adolescents with community deliveries. Maternal anaemia and low birthweight prevalence were lower amongst adolescents in this study compared to estimates from the same population a decade previously. Conclusions. Adolescents had higher anaemia risk, lower IPTp-SP uptake than adults and under a quarter had a hospital delivery. Pregnancy outcomes improved compared to the survey a decade earlier. Monitoring and surveillance is required to reinforce to policy makers the need to improve adolescent coverage for available interventions.

Item Type: Article
Uncontrolled Keywords: Malaria, pregnancy, primigravidae, adolescent, women's health issue in developing countries
Subjects: WC Communicable Diseases > Tropical and Parasitic Diseases > WC 770 Therapy
WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
WA Public Health > Health Problems of Special Population Groups > WA 310 Maternal welfare
WD Disorders of Systemic, Metabolic or Environmental Origin, etc > Nutrition Disorders > WD 105 Deficiency diseases
Faculty: Department: Groups (2002 - 2012) > Child & Reproductive Health Group
Digital Object Identifer (DOI): https://doi.org/10.3109/00016349.2010.487892
Depositing User: Pauline Anderson
Date Deposited: 26 Nov 2010 11:13
Last Modified: 06 Feb 2018 13:00
URI: http://archive.lstmed.ac.uk/id/eprint/1078

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