Introduction Ghana adopted the revised WHO recommendation on intermittent preventive treatment in pregnancy using sulfadoxine-pyrimethamine (IPTp-SP) in 2012. This study has assessed the effectiveness and safety of this policy in Ghana. Methods A total of 1926 pregnant women enrolled at antenatal care (ANC) clinics were assessed for birth outcomes at delivery, and placental histology results for malaria infection were obtained from 1642 participants. Association of reduced placental or peripheral malaria, anaemia and low birth weight (LBW) in women who received ≥4 IPTp-SP doses compared with 3 or ≤2 doses was determined by logistic regression analysis. Results Among the 1926 participants, 5.3% (103), 19.2% (369), 33.2% (640) and 42.3% (817) of women had received ≤1, 2, 3 or ≥4 doses, respectively. There was no difference in risk of active placental malaria (PM) infection in women who received 3 doses compared with ≥4 doses (adjusted OR (aOR) 1.00, 95% CI 0.47 to 2.14). The risk of overall PM infection was 1.63 (95% CI 1.07 to 2.48) in 2 dose group and 1.06 (95% CI 0.72 to 1.57) in 3 dose group compared with ≥4 dose group. The risk of LBW was 1.55 (95% CI 0.97 to 2.47) and 1.06 (95% CI 0.68 to 1.65) for 2 and 3 dose groups, respectively, compared with the ≥4 dose group. Jaundice in babies was present in 0.16%, and 0% for women who received ≥4 doses of SP. Conclusion There was no difference in the risk of PM, LBW or maternal anaemia among women receiving 3 doses compared with ≥4 doses. Receiving ≥3 IPTp-SP doses during pregnancy was associated with a lower risk of overall PM infection compared with 2 doses. As there are no safety concerns, monthly administration of IPTp-SP offers a more practical opportunity for pregnant women to receive ≥3 doses during pregnancy. Data are available upon reasonable request.

中文翻译：

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在加纳使用磺胺多辛-乙胺嘧啶 (IPTp-SP) 进行间歇性妊娠预防性治疗的有效性

引言 加纳于 2012 年采纳了世卫组织关于使用磺胺多辛-乙胺嘧啶 (IPTp-SP) 进行妊娠间歇性预防性治疗的修订建议。本研究评估了该政策在加纳的有效性和安全性。方法 共有 1926 名在产前保健 (ANC) 诊所登记的孕妇接受了分娩时的出生结果评估，并从 1642 名参与者中获得了疟疾感染的胎盘组织学结果。通过逻辑回归分析确定接受 ≥ 4 剂 IPTp-SP 与 3 剂或≤ 2 剂的妇女的胎盘或外周疟疾、贫血和低出生体重 (LBW) 减少之间的关联。结果 在 1926 名参与者中，分别有 5.3% (103)、19.2% (369)、33.2% (640) 和 42.3% (817) 的女性接受了≤1、2、3 或≥4 剂的剂量。与≥4 剂相比，接受 3 剂的女性感染活动性胎盘疟疾 (PM) 的风险没有差异（调整后的 OR (aOR) 1.00，95% CI 0.47 至 2.14）。与≥4剂量组相比，2剂量组总体PM感染风险为1.63（95% CI 1.07至2.48），3剂量组为1.06（95% CI 0.72至1.57）。与≥4 剂量组相比，2 和 3 剂量组的 LBW 风险分别为 1.55（95% CI 0.97 至 2.47）和 1.06（95% CI 0.68 至 1.65）。婴儿黄疸的发生率为 0.16%，接受 ≥ 4 剂 SP 的女性为 0%。结论 接受 3 剂与 ≥ 4 剂的妇女在 PM、LBW 或母体贫血的风险上没有差异。与 2 剂相比，在怀孕期间接受 ≥ 3 剂 IPTp-SP 与总体 PM 感染风险较低相关。由于没有安全问题，每月给予 IPTp-SP 为孕妇在怀孕期间接受≥3 剂提供了更实际的机会。可应合理要求提供数据。