دورية أكاديمية
Intermittent preventive treatment with sulphadoxine-pyrimethamine but not dihydroartemisinin-piperaquine modulates the relationship between inflammatory markers and adverse pregnancy outcomes in Malawi.
| العنوان: | Intermittent preventive treatment with sulphadoxine-pyrimethamine but not dihydroartemisinin-piperaquine modulates the relationship between inflammatory markers and adverse pregnancy outcomes in Malawi. |
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| المؤلفون: | Cheng K; Department of Medicine (RMH), The Peter Doherty Institute of Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia., Aitken EH; Department of Infectious Diseases, The Peter Doherty Institute of Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia.; Department of Microbiology and Immunology, The Peter Doherty Institute of Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia., Hasang W; Department of Infectious Diseases, The Peter Doherty Institute of Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia., Meagher N; Department of Infectious Diseases, The Peter Doherty Institute of Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia., Price DJ; Department of Infectious Diseases, The Peter Doherty Institute of Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia.; Centre for Epidemiology & Biostatistics, Melbourne School of Population & Global Health, University of Melbourne, Melbourne, Victoria, Australia., Madanitsa M; Department of Clinical Sciences, Academy of Medical Sciences, Malawi University of Science and Technology, Thyolo, Malawi.; Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom., Mwapasa V; Department of Epidemiology and Biostatistics, School of Global and Public Health, Kamuzu University of Health Sciences, Blantyre, Malawi., Phiri KS; Department of Epidemiology and Biostatistics, School of Global and Public Health, Kamuzu University of Health Sciences, Blantyre, Malawi.; Training and Research Unit of Excellence, Blantyre, Malawi., Dodd J; Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom., Ter Kuile FO; Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom., Rogerson SJ; Department of Medicine (RMH), The Peter Doherty Institute of Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia.; Department of Infectious Diseases, The Peter Doherty Institute of Infection and Immunity, University of Melbourne, Melbourne, Victoria, Australia. |
| المصدر: | PLOS global public health [PLOS Glob Public Health] 2024 May 16; Vol. 4 (5), pp. e0003198. Date of Electronic Publication: 2024 May 16 (Print Publication: 2024). |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Public Library of Science Country of Publication: United States NLM ID: 9918283779606676 Publication Model: eCollection Cited Medium: Internet ISSN: 2767-3375 (Electronic) Linking ISSN: 27673375 NLM ISO Abbreviation: PLOS Glob Public Health Subsets: PubMed not MEDLINE |
| أسماء مطبوعة: | Original Publication: San Francisco, California : Public Library of Science, [2021]- |
| مستخلص: | Women in malaria-endemic areas receive sulphadoxine-pyrimethamine (SP) as Intermittent Preventive Treatment in Pregnancy (IPTp) to reduce malaria. While dihydroartemisinin-piperaquine (DP) has superior antimalarial properties as IPTp, SP is associated with superior fetal growth. As maternal inflammation influences fetal growth, we investigated whether SP alters the relationship between inflammation and birth outcomes. We measured C-reactive protein (CRP) and alpha-1-acid glycoprotein (AGP) at enrollment (16-28 gestation weeks (gw)), visit 3 (24-36 gw) and delivery in 1319 Malawian women randomized to receive monthly SP, DP, or DP and single-dose azithromycin (AZ) in the IMPROVE trial (NCT03208179). Logistic regression was used to assess the relationship between adverse outcomes, inflammation, and treatment arm. Elevated AGP at enrollment was associated with adverse birth outcome (aRR 1.40, 95% CI: 1.15, 1.70), with similar associations observed across treatment arms, exceptions being that elevated AGP was associated with low maternal weight gain in SP recipients (aRR 1.94, 95% CI: 1.36, 2.76) and with small for gestational age in DP+AZ recepients (aRR 1.49, 95% CI 1.02, 2.17). At visit 3 there were few associations between inflammation andoutcomes. At delivery, women with elevated AGP receiving either DP or DP+AZ had an increased risk of adverse birth outcomes (aRR 1.60, 95% CI: 1.28, 2.00), including low birth weight, pre-term birth and foetal loss, this was not seen in women receiving SP (aRR 0.82, 95% CI: 0.54, 1.26). The risk of an association between elevated AGP and adverse birth outcome was higher in those receiving DP or DP+AZ compared to those receiving SP (aRR 1.95, 95% CI: 1.21, 3.13). No clear associations between CRP and adverse outcomes were observed. AGP identified women at risk of adverse pregnancy outcomes. SP modifies the relationship between inflammatory biomarkers and adverse outcomes. Our findings provide insights into potential mechanisms by which SP may improve pregnancy outcomes. Competing Interests: The authors have declared that no competing interests exist. (Copyright: © 2024 Cheng et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.) |
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| تواريخ الأحداث: | Date Created: 20240516 Latest Revision: 20240518 |
| رمز التحديث: | 20240518 |
| مُعرف محوري في PubMed: | PMC11098340 |
| DOI: | 10.1371/journal.pgph.0003198 |
| PMID: | 38753813 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 2767-3375 |
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| DOI: | 10.1371/journal.pgph.0003198 |