A randomized, placebo-controlled trial of intermittent preventive treatment with sulphadoxine-pyrimethamine in Gambian multigravidae
A randomized, placebo-controlled trial of intermittent preventive treatment with sulphadoxine-pyrimethamine in Gambian multigravidae
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DOI：
10.1111/j.1365-3156.2006.01649.x
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发表时间：
2006-07-01
影响因子：
3.3
通讯作者：
Walraven, G.
中科院分区：
文献类型：
--
作者：
Mbaye, A.;Richardson, K.;Walraven, G.
我们研究了使用磺胺多辛/乙胺嘧啶进行妊娠期间歇性预防治疗 (IPTp) 预防冈比亚多孕妇贫血和低出生体重的能力。 2002年7月至2004年2月期间，生活在冈比亚农村地区的2688名多孕妇在怀孕期间接受了SP（1346名妇女）或安慰剂（1342名妇女）最多四次，并随访至产后6周。分娩后不久，干预组中 10.7% 的女性和对照组中 8.8% 的女性出现严重贫血 [Hb < 7 g/dl，风险差异 = 0.02 (95% CI 0.01, 0.04)，P = 0.17]。接受 SP 的女性所生婴儿的总体平均出生体重（3103 克）与对照组女性所生婴儿的总体平均出生体重（3075 克；3075 克）非常相似。差异 = 28 g（95% CI 11 g，67 g），P = 0.16]。然而，在未使用蚊帐（无论是否经过杀虫剂处理）的女性中，接受 SP 的女性所生的婴儿比对照组女性所生的婴儿重 [3147 克 vs. 3044 克；差异 143 g（95% CI 53 g，232 g），交互作用检验 P < 0.001]。这项研究并未表明带有 SP 的 IPTp 总体上使冈比亚多孕妇受益，但它可能使不使用蚊帐的女性亚群受益。在冈比亚等地区，向多孕妇提供经过杀虫剂处理的蚊帐可能会提供足够的方法来预防怀孕期间的疟疾，而无需额外的IPTp。
We investigated the ability of intermittent preventive treatment in pregnancy (IPTp) with sulphadoxine/pyrimethamine to prevent anaemia and low birthweight in Gambian multigravidae. Between July 2002 and February 2004, 2688 multigravidae living in a rural area of The Gambia received SP (1346 women) or placebo (1342 women) up to four times during pregnancy and were followed until 6-weeks postpartum. Shortly after delivery, 10.7% of women in the intervention group and 8.8% in the control group were severely anaemic [Hb < 7 g/dl, risk difference = 0.02 (95% CI 0.01, 0.04), P = 0.17]. The overall mean birthweight of infants born to women who had received SP ( 3103 g) was very similar to that observed in infants born to women in the control group [3075 g; difference = 28 g (95% CI 11 g, 67 g), P = 0.16]. However, among women who did not use a bednet (either insecticide treated or untreated), infants born to women who had received SP weighed more than infants born to women in the control group [3147 g vs. 3044 g; difference 143 g (95% CI 53 g, 232 g), interaction test P < 0.001]. This study did not show that IPTp with SP benefited Gambian multigravidae overall but that it may benefit a sub-group of women who do not use a bednet. In areas such as The Gambia, provision of insecticide-treated bednets to multigravidae may provide an adequate means of protection against malaria in pregnancy without the need for additional IPTp.