The Effect of Number of Doses of Sulphadoxine-pyrimethamine for Intermittent Preventive Therapy on Pregnancy Outcome Among Parturients Delivering at Lautech Teaching Hospital, Ogbomoso. A Prospective Cross-sectional Study

Abstract

Background Malaria infection during pregnancy is associated with adverse maternal and foetal outcomes especially in sub-Saharan Africa. Sulphadoxine Pyrimethamine (SP) is commonly used for intermittent preventive therapy (IPT) against malaria in pregnancy. However, development of resistance to SP has been linked to reduction in its effectiveness. WHO recommends uptake of SP at each scheduled antenatal care (ANC) visit at least four weekly apart, but the effects of number of doses of SP on pregnancy outcomes still require comprehensive review. Methodology: Study Type: Prospective Cross-sectional Study. Participants were recruited during booking clinic. IPT-SPs were administered to participants in ANC under directly observed therapy (DOT) at least four weekly apart and recorded in the ANC case note and they were followed up till delivery. Data obtained was analysed using Statistical Product and Service Solutions (SPSS) version 21 Results A total of two hundred and ten (210) participants were recruited into the study, 192 (91.43%) participants completed the study. The median number of doses of IPT-SP received by the study participants is three (3) doses. Increasing number of doses of IPT-SP was significantly associated with reduction in LBW (P < 0.001), symptomatic maternal malaria episode (p = 0.028), maternal anaemia in 3rd trimester (p < 0.001) and at delivery (p < 0.001) (most significantly in primigravida) and non-significant reduction in preterm delivery (p = 0.1). There was no significant difference in the proportion of women reporting adverse drug reactions among the number of doses (p = 0.395). Conclusion Four or more doses of IPT with SP was considerably more effective in reducing symptomatic malaria, maternal and neonatal anaemia, low birth weight and premature delivery than 2-dose regimen even in this area with low SP resistance and highly seasonal malaria and the extra dose of SP was well tolerated. Recommendation: Pregnant women should be encouraged to receive four or more doses of IPT-SP in pregnancy.