Effect of repeated treatment of pregnant women with sulfadoxine-pyrimethamine and azithromycin on preterm delivery in Malawi: a randomized controlled trial.
Preterm delivery, which is associated with infections during pregnancy, is common in sub-Saharan Africa. We enrolled 1,320 pregnant women into a randomized, controlled trial in Malawi to study whether preterm delivery and low birth weight (LBW) incidence can be reduced by intermittent preventive treatment of maternal malaria and reproductive tract infections. The participants received either sulfadoxine-pyrimethamine (SP) twice (controls), monthly SP, or monthly SP and two doses of azithromycin (AZI-SP). The incidence of preterm delivery was 17.9% in controls, 15.4% in the monthly SP group (P = 0.32), and 11.8% in AZI-SP group (risk ratio = 0.66, P = 0.01). Compared with controls, those in AZI-SP group had a risk ratio of 0.61 (P = 0.02) for LBW. Incidence of serious adverse events was low in all groups. In conclusion, the incidence of preterm delivery and LBW can in some conditions be reduced by treating pregnant women with monthly SP and two azithromycin doses.
Department of International Health, University of Tampere Medical School, Tampere, Finland. mari.luntamo@gmail.com
Mari
M
Luntamo
Teija
T
Kulmala
Bernard
B
Mbewe
Yin Bun
YB
Cheung
Kenneth
K
Maleta
Per
P
Ashorn
D000293:Adolescent; D000328:Adult; D017963:Azithromycin / Q000008:administration & dosage* / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D004338:Drug Combinations; D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008295:Malawi / Q000453:epidemiology; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic / Q000188:drug therapy; D047928:Premature Birth / Q000517:prevention & control*; D011739:Pyrimethamine / Q000008:administration & dosage* / Q000627:therapeutic use*; D013413:Sulfadoxine / Q000008:administration & dosage* / Q000627:therapeutic use*; D055815:Young Adult
D004338:Drug Combinations; C001205:fanasil, pyrimethamine drug combination; D017963:Azithromycin; D013413:Sulfadoxine; D011739:Pyrimethamine