Antenatal interventions to reduce risk of low birth weight related to maternal infections during pregnancy

Yvonne Muthiani; Patricia J Hunter; Pieta K Näsänen-Gilmore; Annariina M Koivu; Jaana Isojärvi; Juho Luoma; Meeri Salenius; Maryam Hadji; Ulla Ashorn; Per Ashorn

doi:10.1016/j.ajcnut.2023.02.025

Antenatal interventions to reduce risk of low birth weight related to maternal infections during pregnancy

Am J Clin Nutr. 2023 Jun:117 Suppl 2:S118-S133. doi: 10.1016/j.ajcnut.2023.02.025.

Authors

Affiliations

¹ Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland. Electronic address: yvonne.muthiani@tuni.fi.
² University College London Great Ormond Street Institute of Child Health, London, UK.
³ Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland; Department of Public Health and Welfare, Finnish Institute for Health and Welfare, FI-00271, Helsinki, Finland.
⁴ Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
⁵ Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland; Department of Paediatrics, Tampere University Hospital, Tampere, Finland.

PMID: 37331759
DOI: 10.1016/j.ajcnut.2023.02.025

Abstract

Background: Maternal infections during pregnancy have been linked to increased risk of adverse birth outcomes, including low birth weight (LBW), preterm birth (PTB), small for gestational age (SGA), and stillbirth (SB).

Objectives: The purpose of this article was to summarize evidence from published literature on the effect of key interventions targeting maternal infections on adverse birth outcomes.

Methods: We searched MEDLINE, Embase, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and CINAHL Complete between March 2020 and May 2020 with an update to cover until August 2022. We included randomized controlled trials (RCTs) and reviews of RCTs of 15 antenatal interventions for pregnant women reporting LBW, PTB, SGA, or SB as outcomes.

Results: Of the 15 reviewed interventions, the administration of 3 or more doses of intermittent preventive treatment in pregnancy with sulphadoxine-pyrimethamine [IPTp-SP; RR: 0.80 (95% CI: 0.69, 0.94)] can reduce risk of LBW compared with 2 doses. The provision of insecticide-treated bed nets, periodontal treatment, and screening and treatment of asymptomatic bacteriuria may reduce risk of LBW. Maternal viral influenza vaccination, treatment of bacterial vaginosis, intermittent preventive treatment with dihydroartemisinin-piperaquine compared with IPTp-SP, and intermittent screening and treatment of malaria during pregnancy compared with IPTp were deemed unlikely to reduce the prevalence of adverse birth outcomes.

Conclusions: At present, there is limited evidence from RCTs available for some potentially relevant interventions targeting maternal infections, which could be prioritized for future research.

Keywords: antenatal care; low birth weight; low- and middle-income countries; maternal infections; pregnancy; preterm birth; small for gestational age; stillbirth.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Antimalarials*
Birth Weight
Female
Humans
Infant, Low Birth Weight
Infant, Newborn
Infant, Small for Gestational Age
Malaria*
Pregnancy
Pregnancy Complications* / drug therapy
Premature Birth* / epidemiology
Premature Birth* / prevention & control
Systematic Reviews as Topic

Substances

Antimalarials