Efficacy of intermittent preventive treatment with sulfadoxine-pyrimethamine on placental parasitemia in pregnant women in midwestern Nigeria.
OBJECTIVE
To assess the effect of intermittent preventive treatment with sulfadoxine and pyrimethamine (IPT-SP) on placental parasitemia and maternal and perinatal outcome.


METHODS
We compared placental malaria parasitemia during pregnancy and pregnancy outcome in 2 groups of women receiving antenatal care at University of Benin Teaching Hospital. One group was prophylactically treated with IPT-SP and the other was not treated.


RESULTS
The parasitemia rates for peripheral, placental, and cord blood were 11.9%, 11.4%, and 2.7% in the IPT-SP group (n=370) and 19.1%, 22.6%, and 6.2% in the control group (n=371) (P=0.006, P=0.002, and P=0.02, respectively). The treatment reduced the odds of placental parasitemia by 37% (OR 0.63; 95% CI, 0.48-0.81). Peripheral (P=0.002) and placental (P=0.001) parasitemia were significantly reduced in the subgroup of women who took 2 or 3 doses of SP. Fewer women (16.2%) in the IPT-SP group than the control group (23.7%) had symptomatic malaria. Anemia at delivery was significantly lower in the IPT-SP group (10.8 vs 1.6%). The risks of abortion, preterm delivery, and low birth weight were also significantly lower in the IPT-SP group.


CONCLUSIONS
IPT-SP is effective in preventing placental parasitemia, and reduces rates of malaria, maternal anemia, abortion, preterm delivery and low birth weight among pregnant women.
Department of Obstetrics and Gynecology, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria. michelaziken@hotmail.com
Michael E
ME
Aziken
Kenneth K
KK
Akubuo
Etedafe P
EP
Gharoro
D000328:Adult; D000740:Anemia / Q000453:epidemiology; D000962:Antimalarials / Q000008:administration & dosage / Q000627:therapeutic use*; D015331:Cohort Studies; D004338:Drug Combinations; D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology; D018512:Parasitemia / Q000453:epidemiology / Q000469:parasitology / Q000517:prevention & control*; D010922:Placenta Diseases / Q000469:parasitology / Q000517:prevention & control; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic / Q000517:prevention & control*; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000453:epidemiology; D011446:Prospective Studies; D011739:Pyrimethamine / Q000008:administration & dosage / Q000627:therapeutic use*; D013413:Sulfadoxine / Q000008:administration & dosage / Q000627:therapeutic use*; D055815:Young Adult
D000962:Antimalarials; D004338:Drug Combinations; C001205:fanasil, pyrimethamine drug combination; D013413:Sulfadoxine; D011739:Pyrimethamine