Department of Paediatrics, College of Medicine, University of Ibadan, University College Hospital, Ibadan, Nigeria.
BMC Pregnancy Childbirth. 2011 Aug 18;11:60. doi: 10.1186/1471-2393-11-60.
Malaria remains a major public health problem in sub Saharan Africa and the extent of utilisation of malaria preventive measures may impact on the burden of malaria in pregnancy. This study sought to determine the association between malaria preventive measures utilized during pregnancy and the birth outcomes of birth weight and preterm delivery.
This cross sectional survey involved 800 mothers who delivered at the University College Hospital, and Adeoyo Maternity Hospital, Ibadan. Data obtained included obstetric information, gestational age, birth weight and self reported use of malaria prevention strategies in index pregnancy.
Most (95.6%) mothers used one or more malaria control measures. The most commonly used vector control measures were window net (84.0%), insecticide spray (71.5%) and insecticide treated bed nets (20.1%), while chemoprophylactic agents were pyrimethamine (23.5%), Intermittent Preventive Treatments with Sulphadoxine-Pyrimethamine (IPTsp) (18.5%) and intermittent chloroquine (9.5%) and 21.7% used herbal medications. The mean ± SD birthweight and gestational age of the babies were 3.02 kg ± 0.56 and 37.9 weeks ± 2.5 respectively. Preterm delivery rate was 19.4% and 9% had low birth weight. Comparing babies whose mothers had IPTsp with those who did not, mean birth weight was 3.13 kg ± 0.52 versus 3.0 kg ± 0.56 (p = 0.016) and mean gestational age was 38.5 weeks ± 2.1 versus 37.8 weeks ± 2.5 (p = 0.002). The non-use of IPTsp was associated with increased risk of having low birth weight babies (AOR: 2.27, 95% CI: 0.98; 5.28) and preterm birth (AOR: 1.93, 95% CI: 1.08, 3.44). The non use of herbal preparations (AOR: 0.55, 95% CI: 0.36, 0.85) was associated with reduced risk of preterm birth. The mean ± SD birth weight and gestational ages of babies born to mothers who slept under ITNs were not significantly different from those who did not (p = 0.07 and 0.09 respectively).
There is a need for improved utilisation of IPTsp as well as discouraging the use of herbal medications in pregnancy in order to reduce pregnancy outcome measures of low birth weight and preterm deliveries in this environment.
疟疾仍然是撒哈拉以南非洲地区的一个主要公共卫生问题，疟疾预防措施的利用程度可能会影响妊娠期间疟疾的负担。本研究旨在确定妊娠期间使用的疟疾预防措施与出生体重和早产之间的关系。
本横断面研究纳入了在伊巴丹大学教学医院和阿德约产科医院分娩的 800 名母亲。获得的数据包括产科信息、孕龄、出生体重和自我报告的在指数妊娠期间使用疟疾预防策略。
大多数（95.6%）母亲使用了一种或多种疟疾控制措施。最常用的病媒控制措施是窗纱（84.0%）、杀虫剂喷雾（71.5%）和杀虫剂处理过的蚊帐（20.1%），而化学预防药物为乙嘧啶（23.5%）、磺胺多辛-乙嘧啶间歇性预防治疗（IPTsp）（18.5%）和间歇性氯喹（9.5%），21.7%的人使用草药药物。婴儿的平均（±SD）出生体重和胎龄分别为 3.02 千克（±0.56）和 37.9 周（±2.5）。早产率为 19.4%，9%的婴儿出生体重低。与未使用 IPTsp 的母亲所生婴儿相比，使用 IPTsp 的母亲所生婴儿的平均出生体重为 3.13 千克（±0.52）与 3.0 千克（±0.56）（p=0.016），平均胎龄为 38.5 周（±2.1）与 37.8 周（±2.5）（p=0.002）。不使用 IPTsp 与出生体重低的婴儿（优势比：2.27，95%置信区间：0.98；5.28）和早产（优势比：1.93，95%置信区间：1.08，3.44）的风险增加有关。不使用草药制剂（优势比：0.55，95%置信区间：0.36，0.85）与早产风险降低有关。在 ITN 下睡觉的母亲所生婴儿的平均（±SD）出生体重和胎龄与未使用 ITN 的母亲所生婴儿的平均（±SD）出生体重和胎龄没有显著差异（分别为 p=0.07 和 0.09）。
需要改善 IPTsp 的利用，并劝阻孕妇使用草药药物，以降低这种环境中低出生体重和早产的妊娠结局。
