Intermitent presumptive treatment of malaria to prevent low birth weight in newborns in a cohort of pregnant women from a malaria endemic area

Abstract

To determine and describe the patterns of low birth weight in newborns of a cohort of mothers given intermittent presumptive treatment (IPT) for malaria prevention in a malaria endemic area of Kenya. A longitudinal prospective cohort study. Got Agulu Health Centre in Usigu Division, Bondo District, Nyanza Province. Pregnant women of all parities attending antenatal care services. Only women who gave informed consent for themselves and their newborns after birth were eligible to participate in the study. Parity was highly predictive of birth weight in the study subjects. Primigravidae and secondigravidae had a significantly lower mean birth weight (2952g) than women of higher gravidity (3214g) p-value <0.0001. Regardless of IPT administration, women who became positive for malaria infection at any point during pregnancy delivered 73.7% of the LBW infants. There was no significant difference in mean birth weights between primigravidae and multigravidae who had parasitaemia at baseline and at delivery (means 2906g and 3062g respectively, p=0.11). However, there was a significant difference between the parasitaemia negative primigravidae and multigravidae at baseline and at delivery (means 2952g and 3204g respectively, p=0.006). Infection with helminths did not have an effect on birth weight. Overall, low birth weight was observed in 9% of the newborns and was most commonly found in primigravidae and secondigravidae (14.8% and 13.1% respectively). Although many factors have been known to play a role in the causation of low birth weight (LBW <2500g), parity status and malaria infection in malaria endemic areas still play a major role regardless of IPT administration.