重复使用磺胺多辛-乙胺嘧啶和阿奇霉素治疗孕妇对马拉维早产的影响：一项随机对照试验。
Effect of repeated treatment of pregnant women with sulfadoxine-pyrimethamine and azithromycin on preterm delivery in Malawi: a randomized controlled trial.
机构信息
Department of International Health, University of Tampere Medical School, Tampere, Finland.
出版信息
Am J Trop Med Hyg. 2010 Dec;83(6):1212-20. doi: 10.4269/ajtmh.2010.10-0264.
Abstract
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.
摘要
早产与怀孕期间的感染有关，在撒哈拉以南非洲很常见。我们在马拉维招募了 1320 名孕妇参加一项随机对照试验，以研究间歇性预防母亲疟疾和生殖道感染是否可以降低早产和低出生体重（LBW）的发生率。参与者接受了磺胺多辛-乙胺嘧啶（SP）两次（对照组）、每月 SP 或每月 SP 和两剂阿奇霉素（AZI-SP）。对照组早产发生率为 17.9%，每月 SP 组为 15.4%（P=0.32），AZI-SP 组为 11.8%（风险比=0.66，P=0.01）。与对照组相比，AZI-SP 组的 LBW 风险比为 0.61（P=0.02）。所有组的严重不良事件发生率均较低。总之，在某些情况下，每月 SP 和两剂阿奇霉素治疗孕妇可以降低早产和 LBW 的发生率。
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本文引用的文献
1
The worldwide incidence of preterm birth: a systematic review of maternal mortality and morbidity.全球早产发生率：孕产妇死亡和发病的系统评价。
Bull World Health Organ. 2010 Jan;88(1):31-8. doi: 10.2471/BLT.08.062554. Epub 2009 Sep 25.
2
The APPLe study: a randomized, community-based, placebo-controlled trial of azithromycin for the prevention of preterm birth, with meta-analysis.APPLe 研究：阿奇霉素预防早产的随机、社区为基础、安慰剂对照试验，荟萃分析。
PLoS Med. 2009 Dec;6(12):e1000191. doi: 10.1371/journal.pmed.1000191. Epub 2009 Dec 1.
3
Childhood outcomes after prescription of antibiotics to pregnant women with spontaneous preterm labour: 7-year follow-up of the ORACLE II trial.对自然早产孕妇使用抗生素后的儿童期结局：ORACLE II试验的7年随访
Lancet. 2008 Oct 11;372(9646):1319-27. doi: 10.1016/S0140-6736(08)61203-9. Epub 2008 Sep 17.
4
Long-term medical and social consequences of preterm birth.早产的长期医学和社会后果。
N Engl J Med. 2008 Jul 17;359(3):262-73. doi: 10.1056/NEJMoa0706475.
5
Antenatal lower genital tract infection screening and treatment programs for preventing preterm delivery.预防早产的产前下生殖道感染筛查与治疗方案
Cochrane Database Syst Rev. 2008 Apr 16(2):CD006178. doi: 10.1002/14651858.CD006178.pub2.
6
Systematic review of the efficacy and effectiveness of complementary feeding interventions in developing countries.发展中国家辅食添加干预措施的疗效和效果的系统评价。
Matern Child Nutr. 2008 Apr;4 Suppl 1(Suppl 1):24-85. doi: 10.1111/j.1740-8709.2007.00124.x.
7
An overview of mortality and sequelae of preterm birth from infancy to adulthood.从婴儿期到成年期早产的死亡率和后遗症概述。
Lancet. 2008 Jan 19;371(9608):261-9. doi: 10.1016/S0140-6736(08)60136-1.
8
Maternal and child undernutrition: consequences for adult health and human capital.母婴营养不良：对成人健康和人力资本的影响。
Lancet. 2008 Jan 26;371(9609):340-57. doi: 10.1016/S0140-6736(07)61692-4.
9
Epidemiology and causes of preterm birth.早产的流行病学及病因
Lancet. 2008 Jan 5;371(9606):75-84. doi: 10.1016/S0140-6736(08)60074-4.
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