Summary of findings 8. Summary of findings table 8.
| Intermittent preventive treatment with SP for pregnant women (parity 0‐1) living in malaria endemic areas: infant outcomes | |||||
| Patient or population: Pregnant women (parity 0‐1) Settings: Malaria‐endemic areas Intervention: Intermittent preventive treatment with SP (2 doses, 3 doses, or monthly dosing) Control: Placebo or no intervention | |||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of participants (trials) | Quality of the evidence (GRADE) | |
| Assumed risk | Corresponding risk | ||||
| Control | IPT (SP) | ||||
| Spontaneous abortion | 34 per 1000 | 21 per 1000 (13 to 33) | RR 0.61 (0.38 to 0.99) | 2567 (3 trials) | ⊕⊕⊝⊝ low1,2,3,4 |
| Stillbirth | 33 per 1000 | 32 per 1000 (21 to 49) | RR 0.97 (0.64 to 1.47) | 2703 (3 trials) | ⊕⊕⊝⊝ low2,4,5,6 |
| Perinatal mortality | 80 per 1000 | 62 per 1000 (42 to 94) | RR 0.78 (0.52 to 1.17) | 1237 (1 trial) | ⊕⊕⊝⊝ low7 |
| Neonatal mortality | 37 per 1000 | 23 per 1000 (14 to 39) | RR 0.62 (0.37 to 1.05) | 2156 (2 trials) | ⊕⊕⊝⊝ low2,4,5,6 |
| Preterm birth | 164 per 1000 | 140 per 1000 (108 to 181) | RR 0.85 (0.66 to 1.10) | 1493 (2 trials) | ⊕⊕⊝⊝ low1,2,4 |
| Low birthweight | 128 per 1000 | 104 per 1000 (86 to 127) | RR 0.81 (0.67 to 0.99) | 3043 (4 trials) | ⊕⊕⊕⊝ moderate8,9 |
| Mean birthweight | The mean birthweight in the control groups ranged from 2908 g to 3079 g |
The mean birthweight in the intervention groups was 84.18 g higher (40.1 to 128.3 higher) | ‐ | 2127 (3 trials) | ⊕⊕⊕⊝ moderate5,9 |
| Placental parasitaemia | 225 per 1000 | 101 per 1000 (74 to 137) | RR 0.45 (0.33 to 0.61) | 1633 (3 trials) | ⊕⊕⊕⊝ moderate5,10 |
| Cord blood haemoglobin | ‐ | ‐ | ‐ | ‐ (0 trials) |
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| *The basis for the assumed risk (eg the median control group risk across trials) is provided in footnotes. The corresponding risk (and its 95% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; RR: Risk ratio. | |||||
| GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. | |||||
1 Downgraded by 1 for serious risk of bias: None of the trials described adequate measures to prevent selection bias. 2 No serious inconsistency: The effect is consistent across trials and statistical heterogeneity is low 3 No serious indirectness: These trials were conducted in the Kenya and Mozambique between 1996 and 2002. 4 Downgraded by 1 for serious imprecision: The 95% CI is wide and sample remains underpowered to detect or rule out an effect. 5 Downgraded by 1 for serious risk of bias: Only one trial adequately described methods to prevent selection bias. 6 No serious indirectness: Trials were conducted in Kenya between 1996 and 1997. 7 Downgraded by 2 for serious imprecision: The 95% CI is wide and sample remains underpowered to detect or rule out an effect. 8 Downgraded by 1 for serious risk of bias: Only two of these trials were at low risk of selection bias. 9 No serious indirectness: These trials were conducted in the Kenya, Uganda and Mozambique between 1996 and 2008. 10 No serious inconsistency: Although statistical heterogeneity was high, all trials favoured chemoprevention but there was variability in the size of the effect.