Influence of Intermittent Preventive Treatment with Sulphadoxine – Pyrimethamine (IPT-SP) on Neonatal Clinical Characteristics during Delivery at Owerri, South East, Nigeria
Keywords:
APGAR score, Birth weight, IPT-SP, Malaria in Pregnancy, PlasmodiumAbstract
Background: Malaria is a disease caused by a protozoan organism, the Plasmodium. The disease is endemic in the tropical areas of the world majorly, the Sub-Saharan Africa and to a lesser extent Asia. About 4 species of the Plasmodium (falciparum, vivax, ovale and malariae) which are transmitted by the female anopheles’ mosquitoes essentially causes this disease in man. The disease has severe consequences especially on children, pregnant mothers and the elderly. The problems of malaria in pregnancy (MIP) are enormous, affecting both the mother (miscarriages, premature labour, and even maternal deaths etc) and her unborn baby (fetal abortions, preterm births, intrauterine growth restrictions (IUGR), small for date babies, poor APGAR scores at birth, increased admissions in the neonatal intensive care unit (NICU), low birth weights, even fetal losses and neonatal deaths etc). These innumerable consequences warranted the World Health Organization (WHO) to recommend and approve the use of Intermittent Preventive Treatment with Sulphadoxine Pyrimethamine (IPT-SP) for the prevention of Malaria in Pregnancy.
Aim: Primarily, we aimed to study some clinical characteristics of neonates born to mothers who received IPT-SP in their current pregnancies and to compare same with the non-IPT-SP born Neonates.
Methods: The main material for the study is Sulphadoxine Pyrimethamine that were administered longitudinally as Directly Observed Treatment (DOT) to 148 eligible mothers at varying gestational ages from the second trimester. These mothers were followed them up during their antenatal course to help collect as well as analyze their pregnancy outcomes including the clinical characteristics and then compare same with the outcomes of the other 148 recruited mothers who were not SP eligible. IPT-SP non eligible mothers have allergies to SP or wee recruited while in labour. The conditions for eligibility were based on set inclusion and exclusion criteria. The pregnancy outcome of interest in this very study included the APGAR Scores at 1st minute, APGAR scores at 5th minute and Neonatal Birth weights.
Data Analysis: The results were subjected to statistical process in which data obtained was analyzed using the SPSS (Computer Software Package for Social Sciences) version 20.0 (SPSS, Inc, 2007, Chicago). The descriptive statistics (mean, standard deviation, percentages etc.) were arrived at for continuous variables. For the purpose of this study, any P-value less than (<) 0.05 was considered statistically significant at 95% confidence interval.
Results: The mean Apgar score at 1 minute was 8.0 ± 1.81 for the study group neonates and only 6.5 ± 2.41 for those in the control group. The average Apgar score at 5 minutes was 9.0 ± 1.71 for the study group neonates and only 8.0 ± 3.06 for the control. The study group neonatal mean Birth weight was 3.162 kg ± 0.53 kg, while 2.714 kg ± 0.94 kg was for the control neonates.
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