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

  • Jordan E. Cates
  • , Daniel Westreich
  • , Holger W. Unger
  • , Melissa Bauserman
  • , Linda Adair
  • , Stephen R. Cole
  • , Steven Meshnick
  • , Stephen J. Rogerson
  • , V. Briand
  • , N. Fievet
  • , I. Valea
  • , H. Tinto
  • , U. D'Alessandro
  • , S. H. Landis
  • , A. Lartey
  • , K. G. Dewey
  • , F. O. TerKuile
  • , Stephanie Dellicour
  • , Anna Van Eijk
  • , M. Desai
  • M. Owidhi, A. L'Ianziva, G. Aol, V. Were, Simon Kariuki, J. Ayisi, Anja Terlouw, M. Madanitsa, V. Mwapasa, K. Maleta, P. Ashorn, I. Mueller, D. Stanisic, C. Schmiegelow, J. P.A. Lusingu
  • University of North Carolina at Chapel Hill
  • University of Melbourne
  • Paris Descartes University
  • Institut de Recherche en Sciences de la Santé-DRO
  • Centre MURAZ
  • Medical Research Council
  • GlaxoSmithKline
  • University of Ghana
  • University of California at Davis
  • Liverpool School of Tropical Medicine
  • Centers for Disease Control and Prevention
  • Kenya Medical Research Institute
  • University of Malawi
  • Tampere University
  • Walter and Eliza Hall Institute of Medical Research
  • Griffith University Queensland
  • University of Copenhagen

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)399-406
Number of pages8
JournalAmerican Journal of Public Health
Volume108
Issue number3
Early online date18 Jan 2018
DOIs
Publication statusPublished - 1 Mar 2018

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

  1. SDG 3 - Good Health and Well-being
    SDG 3 Good Health and Well-being

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