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Table 14 Impact of anti-malarials in pregnancy in malaria-endemic areas on stillbirth and perinatal mortality

From: Reducing stillbirths: prevention and management of medical disorders and infections during pregnancy

Source

Location and Type of Study

Intervention

Stillbirths/Perinatal Outcomes

Reviews and meta-analyses

Garner et al. 2006 [155]

Burkina Faso, Cameroon, Gambia, Nigeria, Uganda, Thailand, Kenya.

Meta-analysis (Cochrane). 9 RCTs included.

Assessed 1) the impact of treating malaria with any anti-malarial drug (intervention #1) vs. no drug (control #1), and 2) preventing malaria with any anti-malarial drug (intervention #2) vs. no drug (control #2).

PMR (treatment): RR = 1.02 (95% CI: 0.73–1.43) [NS] in intervention group #1 vs. control group #1, respectively.

PMR (prevention): RR = 0.73 (95% CI: 0.53–0.99) in intervention group #2 vs. control group #2, respectively.

Intervention studies

Hamer et al. 2007 [156]

Zambia (Ndola), urban setting.

Cluster RCT. N = 456 HIV-positive mothers (N = 224 intervention group, N = 232 controls).

Compared 2 dosing schedules for malaria prevention: 1 treatment course of SP per month (intervention) vs. 1 course of SP per trimester (controls).

SBR: RR = 0.43 (95% CI:

0.1–2.2) [NS]

[2/191 vs. 5/203 in intervention vs. control groups, respectively.]

Observational studies

Verhoeff et al. 1999 [202]

Malawi (Chikwawa district), rural setting.

Prospective cohort study. N = 1523 women.

Assessed the impact of antenatal screening and treatment for malaria and anaemia.

SBR: 3.7%

ENND (< 48 h postpartum): 1.7%