Msyamboza Kelias, Savage Emma, Kalanda Gertrude, Kazembe Peter, Gies Sabine, D'Alessandro Umberto, Brabin Bernard J
Malaria Alert Centre, College of Medicine, Blantyre, Malawi.
Acta Obstet Gynecol Scand. 2010 Aug;89(8):1011-6. doi: 10.3109/00016349.2010.487892.
To describe pregnancy outcomes of adolescent and adult primigravidae receiving antimalarials and hematinic supplementation and compare findings with a survey in this area a decade earlier.
Cross-sectional surveys in intervention and control sites.
Community, antenatal and delivery facilities in Chikwawa, Malawi. A rural area with year round malaria transmission.
Data on antenatal attendance, uptake of intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP), birthweight, malaria, anaemia, for 2,152 primigravidae.
Place of delivery, anaemia, malaria, birthweight.
Fewer adolescent than adult primigravidae received >or=2 IPTp-SP doses (66 vs. 77.2%, p < 0.001), although more attended for two or more antenatal visits (92.0 vs. 76.7%, p < 0.001). Only 24.1% of adolescent primigravidae attended for hospital delivery. Women resident in intervention sites receiving IPTp-SP community distribution were more likely to choose a community delivery (p < 0.01), and have higher uptake of IPTp-SP (p = 0.036) than women not resident in these villages. Postnatal malaria prevalence was low and did not differ by age or place of delivery. Postnatal anaemia and low birthweight prevalence were higher in adolescents with community deliveries. Maternal anaemia and low birthweight prevalence were lower amongst adolescents in this study compared to estimates from the same population a decade previously.
Adolescents had higher anaemia risk, lower IPTp-SP uptake than adults and under a quarter had a hospital delivery. Pregnancy outcomes improved compared to the survey a decade earlier. Monitoring and surveillance is required to reinforce to policy makers the need to improve adolescent coverage for available interventions.
描述接受抗疟药和补血剂补充的青春期及成年初产妇的妊娠结局，并将结果与十年前该地区的一项调查进行比较。
在干预和对照地点进行横断面调查。
马拉维奇夸瓦的社区、产前和分娩设施。这是一个全年有疟疾传播的农村地区。
收集2152名初产妇的产前检查、磺胺多辛-乙胺嘧啶间歇性预防治疗（IPTp-SP）的接受情况、出生体重、疟疾、贫血等数据。
分娩地点、贫血、疟疾、出生体重。
接受≥2剂IPTp-SP的青春期初产妇少于成年初产妇（66%对77.2%，p<0.001），不过进行两次或更多次产前检查的青春期初产妇更多（92.0%对76.7%，p<0.001）。只有24.1%的青春期初产妇在医院分娩。接受IPTp-SP社区分发的干预地点的女性比不住在这些村庄的女性更有可能选择在社区分娩（p<0.01），且IPTp-SP的接受率更高（p=0.036）。产后疟疾患病率较低，且在年龄或分娩地点方面无差异。社区分娩的青少年中，产后贫血和低出生体重患病率较高。与十年前同一人群的估计值相比，本研究中青少年的孕产妇贫血和低出生体重患病率较低。
青少年贫血风险更高，IPTp-SP接受率低于成年人，且不到四分之一的青少年在医院分娩。与十年前的调查相比，妊娠结局有所改善。需要进行监测和监督，以向政策制定者强调提高青少年对现有干预措施覆盖率的必要性。
