Document Detail


Trends in pregnancy outcomes in Malawian adolescents receiving antimalarial and hematinic supplements.
MedLine Citation:
PMID:  20528200     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: 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. DESIGN: Cross-sectional surveys in intervention and control sites. SETTING: Community, antenatal and delivery facilities in Chikwawa, Malawi. A rural area with year round malaria transmission. METHODS: Data on antenatal attendance, uptake of intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP), birthweight, malaria, anaemia, for 2,152 primigravidae. OUTCOME MEASURES: Place of delivery, anaemia, malaria, birthweight. RESULTS: 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. CONCLUSIONS: 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.
Authors:
Kelias Msyamboza; Emma Savage; Gertrude Kalanda; Peter Kazembe; Sabine Gies; Umberto D'Alessandro; Bernard J Brabin
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Acta obstetricia et gynecologica Scandinavica     Volume:  89     ISSN:  1600-0412     ISO Abbreviation:  Acta Obstet Gynecol Scand     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-19     Completed Date:  2010-08-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370343     Medline TA:  Acta Obstet Gynecol Scand     Country:  England    
Other Details:
Languages:  eng     Pagination:  1011-6     Citation Subset:  IM    
Affiliation:
Malaria Alert Centre, College of Medicine, Blantyre, Malawi.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Anemia / epidemiology
Antimalarials / therapeutic use*
Cross-Sectional Studies
Delivery, Obstetric
Drug Combinations
Female
Ferrous Compounds / therapeutic use
Folic Acid / therapeutic use
Health Surveys
Hematinics / therapeutic use*
Hospitals / utilization
Humans
Infant, Low Birth Weight
Infant, Newborn
Malaria / prevention & control
Malawi
Pregnancy
Pregnancy Complications, Infectious / prevention & control
Pregnancy Outcome*
Prenatal Care / utilization
Pyrimethamine / therapeutic use
Rural Health Services
Rural Population
Sulfadoxine / therapeutic use
Chemical
Reg. No./Substance:
0/Antimalarials; 0/Drug Combinations; 0/Ferrous Compounds; 0/Hematinics; 2447-57-6/Sulfadoxine; 37338-39-9/sulfadoxine-pyrimethamine; 58-14-0/Pyrimethamine; 59-30-3/Folic Acid; 7720-78-7/ferrous sulfate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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