Sulfadoxine-pyrimethamine exhibits dose-response protection against adverse birth outcomes related to malaria and sexually transmitted and reproductive tract infections
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Authors
Chico, R. Matthew
Chaponda, Enesia Banda
Ariti, Cono
Chandramohan, Daniel
Issue Date
2017-03-02
Type
Article
Language
en_US
Keywords
Malaria , Curable Sexually Transmitted Infections , Antenatal Care , Intermittent Preventive Treatment , Sub-Saharan Africa
Alternative Title
Abstract
Background.
We conducted a prospective cohort study in Zambia among pregnant women who received intermittent preventive treatment using sulfadoxine-pyrimethamine (IPTp-SP).
Methods.
We calculated the odds ratios (ORs) of adverse birth outcomes by IPTp-SP exposure, 0–1 dose (n = 126) vs ≥2 doses (n = 590) and ≥2 doses (n = 310) vs ≥3 doses (n = 280) in 7 categories of malaria infection and sexually transmitted and reproductive tract infections (STIs/RTIs).
Results.
We found no significant differences in baseline prevalence of infection across IPTp-SP exposure groups. However, among women given 2 doses compared to 0–1 dose, the odds of any adverse birth outcome were reduced 45% (OR, 0.55; 95% confidence interval [CI], 0.36, 0.86) and 13% further with ≥3 doses (OR, 0.43; 95% CI, 0.27, 0.68). Two or more doses compared to 0–1 dose reduced preterm delivery by 58% (OR, 0.42; 95% CI, 0.27, 0.67) and 21% further with ≥3 doses (OR, 0.21; 95% CI, 0.13, 0.35). Women with malaria at enrollment who received ≥2 doses vs 0-1 had 76% lower odds of any adverse birth outcome (OR, 0.24; 95% 0.09, 0.66), and Neisseria gonorrhoeae and/or Chlamydia trachomatis had 92% lower odds of any adverse birth outcome (OR, 0.08; 95% CI, 0.01, 0.64). Women with neither a malaria infection nor STIs/RTIs who received ≥2 doses had 73% fewer adverse birth outcomes (OR, 0.27; 95% CI, 0.11, 0.68).
Conclusions.
IPTp-SP appears to protect against malaria, STIs/RTIs, and other unspecified causes of adverse birth outcome.
Description
Citation
Chico, R. M., Chaponda, E. B., Ariti, C., & Chandramohan, D. (2017). Sulfadoxine-Pyrimethamine Exhibits Dose-Response Protection Against Adverse Birth Outcomes Related to Malaria and Sexually Transmitted and Reproductive Tract Infections. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 64(8), 1043–1051. https://doi.org/10.1093/cid/cix026
Publisher
Clinical Infectious Diseases : An Official Publication of the Infectious Diseases Society of America