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Intermittent Preventive Therapy in Pregnancy and Incidence of Low Birth Weight in Malaria-Endemic Countries

Cates, Jordan E, Westreich, Daniel, Unger, Holger W, Briand, Valerie, Fievet, Nadine, Valea, Innocent, Tinto, Halidou, D’Alessandro, Umberto, Landis, Sarah H, Lartey, Anna, Dewey, Kathryn G, terKuile, Feiko, Desai, Meghna, Dellicour, Stephanie, Owidhi, Mary, L’Ianziva, Anne, Aol, George, Were, Vincent, Terlouw, Anja, Kariuki, Simon, John, Ayisi, Madanitsa, Mwayi, Mwapasa, Victor, Ashorn, Per, Maleta, Kenneth, Mueller, Ivo, Stanisic, Danielle, Schmiegelow, Christentze, Lusingu, John P. A., vanEijk, Anna, Bauserman, Melissa, Adair, Linda, Cole, Stephen R, Meshnick, Steven and Rogerson, Stephen (2018) 'Intermittent Preventive Therapy in Pregnancy and Incidence of Low Birth Weight in Malaria-Endemic Countries'. The American Journal of Public Health (AJPH), Vol 108, Issue 3, pp. 399-406.

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Abstract

Objectives.
To estimate the impact of hypothetical antimalarial and nutritional interventions (which reduce the prevalence of low midupper arm circumference [MUAC]) on the incidence of low birth weight (LBW).

Methods.
We analyzed data from 14 633 pregnancies from 13 studies conducted across Africa and the Western Pacific from 1996 to 2015. We calculated population intervention effects for increasing intermittent preventive therapy in pregnancy (IPTp), full coverage with bed nets, reduction in malaria infection at delivery, and reductions in the prevalence of low MUAC.

Results.
We estimated that, compared with observed IPTp use, administering 3 or more doses of IPTp to all women would decrease the incidence of LBW from 9.9% to 6.9% (risk difference = 3.0%; 95% confidence interval = 1.7%, 4.0%). The intervention effects for eliminating malaria at delivery, increasing bed net ownership, and decreasing low MUAC prevalence were all modest.

Conclusions.
Increasing IPTp uptake to at least 3 doses could decrease the incidence of LBW in malaria-endemic countries. The impact of IPTp on LBW was greater than the effect of prevention of malaria, consistent with a nonmalarial effect of IPTp, measurement error, or selection bias.

Item Type: Article
Subjects: WA Public Health > WA 30 Socioeconomic factors in public health (General)
WA Public Health > Health Problems of Special Population Groups > WA 309 Women's health
WA Public Health > Health Problems of Special Population Groups > WA 310 Maternal welfare
WC Communicable Diseases > Tropical and Parasitic Diseases > WC 750 Malaria
WC Communicable Diseases > Tropical and Parasitic Diseases > WC 765 Prevention and control
WD Disorders of Systemic, Metabolic or Environmental Origin, etc > Nutrition Disorders > WD 100 General works
WD Disorders of Systemic, Metabolic or Environmental Origin, etc > Nutrition Disorders > WD 105 Deficiency diseases
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI): https://doi.org/10.2105/AJPH.2017.304251
Depositing User: Stacy Murtagh
Date Deposited: 12 Dec 2017 16:08
Last Modified: 08 Feb 2018 14:14
URI: http://archive.lstmed.ac.uk/id/eprint/7879

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