Summary of findings 2. Multigravidae (greater than 2 pregnancies).
| Multigravidae (greater than 2 pregnancies) | ||||||
| Patient or population: HIV‐positive pregnant women Settings: Malaria endemic areas Intervention: Monthly sulfadoxine‐pyrimethamine (SP) compared to standard 2‐dose SP | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of Participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Standard regimen (2 doses) |
Monthly regimen (3 or more doses) |
|||||
| Maternal parasitaemia (at delivery) | 1 per 100 | 1 per 100 (0 to 19) | RR 0.94 (0.06 to 14.75) | 159 (1 study) | ⊕⊝⊝⊝ very low1,2,3 | |
| Placental parasitaemia (at delivery) | 1 per 100 | 3 per 100 (0 to 27) | RR 1.87 (0.17 to 20.23) | 153 (1 study) | ⊕⊝⊝⊝ very low1,2,3 | |
| Maternal anaemia (Hb < 11 g/dL at delivery) | 44 per 100 | 43 per 100 (31 to 62) | RR 0.98 (0.69 to 1.4) | 157 (1 study) | ⊕⊝⊝⊝ very low1,2,3 | |
| Low birth weight (< 2.5 kg) | 9 per 100 | 13 per 100 (5 to 32) | RR 1.41 (0.57 to 3.51) | 155 (1 study) | ⊕⊝⊝⊝ very low1,2,3 | |
| Neonatal mortality | ‐ | ‐ | ‐ | ‐ | ⊕⊝⊝⊝ very low1,2,3,4 | |
| *The basis for the assumed risk (eg the median control group risk across studies) 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 under risk of bias: Both studies had a high proportion of missing outcomes which sensitivity analysis indicates could induce clinically relevant bias. 2 Downgraded by 1 for imprecision: This single trial is too small to have any confidence in this result. 3 Downgraded by 1 for indirectness: This trial was conducted in a low malaria transmission setting and maternal and placental parasitaemia were rare in both groups. 4 This trial did not report neonatal mortality separately for mutigravid women.