RT Journal Article
SR Electronic
T1 Child growth and neurodevelopment after maternal antenatal antibiotic treatment
JF Archives of Disease in Childhood
JO Arch Dis Child
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP 323
OP 328
DO 10.1136/archdischild-2021-322043
VO 107
IS 4
A1 Videman, Karoliina
A1 Hallamaa, Lotta
A1 Heimonen, Otto
A1 Mangani, Charles
A1 Luntamo, Mari
A1 Maleta, Kenneth
A1 Ashorn, Per
A1 Ashorn, Ulla
YR 2022
UL http://adc.bmj.com/content/107/4/323.abstract
AB Objective To assess whether intermittent preventive treatment of pregnant women (IPTp) with sulfadoxine-pyrimethamine (SP) and azithromycin (AZI) in a malaria-endemic area leads to sustained gains in linear growth and development in their offspring.Design Follow-up study of a randomised trial.Setting Mangochi District in rural southern Malawi.Participants 1320 pregnant women and their offspring.Interventions IPTp monthly with SP and twice with AZI (AZI-SP group), monthly with SP but no AZI (monthly SP), or twice with SP (control). No intervention was given to children.Main outcome measures Cognitive performance using Raven’s Coloured Progressive Matrices (CPM) at 13 years of age; mean height and height-for-age Z-score (HAZ), cumulative incidence and prevalence of stunting (HAZ <−2); weight, body mass index, mid-upper-arm circumference and head circumference.Results At approximately 13 years of age, the mean CPM score was 14.3 (SD 3.8, range 6–29, maximum 36), with no differences between groups. Children in the AZI-SP group were on average 0.4 cm (95% CI −0.9 to 1.7, p=0.6) taller than those in the control group. For cumulative incidence of stunting, the HR in the AZI-SP group was 0.72 (95% CI 0.61 to 0.84, p<0.001) compared with the control and 0.76 (95% CI 0.65 to 0.90, p<0.001) compared with the monthly SP groups. There was no intergroup difference in stunting prevalence or anthropometric measurements.Conclusions In rural Malawi, maternal intensified infection control during pregnancy reduces offspring’s cumulative incidence of ever being stunted by 13 years of age. In this study, there was no evidence of a positive impact on cognitive performance.Trial registration number NCT00131235.Data are available upon reasonable request. Data requests from researchers who meet the criteria for access to confidential information can be made to Data Manager Juha Pyykkö (juha.pyykko@tuni.fi).