Cochrane · systematic review · CD000169
Drugs for preventing malaria in pregnant women in endemic areas: any drug regimen versus placebo or no treatment
Radeva‐Petrova, D, Kayentao, K, ter Kuile, FO, et al. · Cochrane Database of Systematic Reviews · 2014 · Cochrane Library
Infectious DiseasesAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
59
current version
GRADE rated
46
No studies
2
Included studies
NR
No studies 2 · 3.4%Ungraded 11 · 18.6%Very low 7 · 11.9%Low 21 · 35.6%Moderate 11 · 18.6%High 7 · 11.9%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Summary of findings table 1
Population: Pregnant women (parity 0‐1)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mortality All‐cause death | RR 1.15 [0.44, 3.06] | 3 studies · 2097 participants | Very low Downgraded: risk of bias, imprecision |
Severe anaemia During the third trimester | RR 0.6 [0.47, 0.75] | 3 studies · 2503 participants | High |
Anaemia | RR 0.83 [0.74, 0.93] | 5 studies · 3662 participants | High |
Uncomplicated clinical malaria | RR 0.37 [0.18, 0.74] | 2 studies · 307 participants | Low Downgraded: risk of bias, inconsistency, indirectness |
Antenatal parasitaemia | RR 0.39 [0.26, 0.58] | 8 studies · 3663 participants | High |
Severe adverse effects12 | no estimate extracted | NR | No studies |
Summary of findings table 2
Population: Pregnant women (parity 0‐1)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Spontaneous abortion | RR 0.65 [0.41, 1.02] | 5 studies · 2876 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Stillbirth | RR 0.97 [0.64, 1.49] | 3 studies · 2703 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Perinatal mortality | RR 0.73 [0.54, 1] | 2 studies · 1620 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Neonatal mortality | RR 0.62 [0.37, 1.05] | 2 studies · 2156 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Preterm birth | RR 0.85 [0.66, 1.1] | 2 studies · 1493 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Low birthweight | RR 0.73 [0.61, 0.87] | 8 studies · 3619 participants | Moderate Downgraded: risk of bias, indirectness |
Mean birthweight | no estimate extracted | 9 studies · 3936 participants | Moderate Downgraded: risk of bias, indirectness |
Placental parasitaemia | RR 0.54 [0.43, 0.69] | 7 studies · 2830 participants | High |
Cord blood haemoglobin | no estimate extracted | 1 study · 64 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Summary of findings table 3
Population: Pregnant women (parity 2+)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mortality All‐cause death | RR 1.47 [0.42, 5.21] | 1 study · 2239 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Severe anaemia During the third trimester | RR 0.96 [0.41, 2.25] | 2 studies · 2682 participants | Low Downgraded: risk of bias, imprecision, indirectness |
Anaemia | no estimate extracted | 1 study · 244 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Uncomplicated clinical malaria | no estimate extracted | 0 studies · 0 participants | Ungraded |
Antenatal parasitaemia | RR 0.38 [0.28, 0.5] | 4 studies · 3022 participants | High |
Severe adverse events11 | no estimate extracted | NR | No studies |
Summary of findings table 4
Population: Pregnant women (parity 2+)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Spontaneous abortion | no estimate extracted | 0 studies · 0 participants | Ungraded |
Stillbirth | no estimate extracted | 0 studies · 0 participants | Ungraded |
Perinatal deaths | no estimate extracted | 0 studies · 0 participants | Ungraded |
Neonatal mortality | RR 1.46 [0.9, 2.38] | 1 study · 2017 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Preterm birth | no estimate extracted | 0 studies · 0 participants | Ungraded |
Low birthweight | RR 0.86 [0.63, 1.17] | 3 studies · 2743 participants | Low Downgraded: risk of bias, imprecision, indirectness |
Mean birthweight | no estimate extracted | 0 studies · 0 participants | Ungraded |
Placental parasitaemia | no estimate extracted | 0 studies · 0 participants | Ungraded |
Cord blood haemoglobin | no estimate extracted | 0 studies · 0 participants | Ungraded |
Summary of findings table 5
Population: Pregnant women (all parities)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mortality All‐cause death | RR 0.84 [0.25, 2.74] | 4 studies · 6026 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Severe anaemia During the third trimester | RR 0.19 [0.05, 0.75] | 2 studies · 1327 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Anaemia | RR 1.03 [0.87, 1.23] | 3 studies · 3027 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Uncomplicated clinical malaria | RR 0.37 [0.11, 1.23] | 4 studies · 3455 participants | Low Downgraded: risk of bias, inconsistency, indirectness |
Antenatal parasitaemia | RR 0.7 [0.44, 1.13] | 4 studies · 3455 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Severe adverse effects12 | no estimate extracted | 0 studies · 0 participants | Ungraded |
Summary of findings table 6
Population: Pregnant women (all parities)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Spontaneous abortion | RR 0.89 [0.58, 1.36] | 3 studies · 5767 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Stillbirth | RR 1.02 [0.76, 1.36] | 5 studies · 7130 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Perinatal mortality | RR 1.24 [0.94, 1.63] | 4 studies · 5216 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Neonatal mortality | RR 0.91 [0.71, 1.16] | 5 studies · 6313 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Preterm birth | RR 0.95 [0.65, 1.38] | 2 studies · 1174 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Low birthweight | RR 1.06 [0.89, 1.27] | 4 studies · 3644 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Mean birthweight | no estimate extracted | 5 studies · 6007 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Placental parasitaemia | RR 0.44 [0.15, 1.29] | 4 studies · 3200 participants | Low Downgraded: risk of bias, inconsistency, indirectness |
Summary of findings table 7
Population: Pregnant women (parity 0‐1)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Mortality All‐cause death | RR 1.15 [0.44, 3.06] | 2 studies · 2097 participants | Very low Downgraded: risk of bias, imprecision |
Severe anaemia During the third trimester | RR 0.6 [0.47, 0.75] | 3 studies · 2503 participants | High |
Anaemia | RR 0.88 [0.81, 0.96] | 4 studies · 3291 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Uncomplicated clinical malaria | RR 0.24 [0.05, 1.12] | 1 study · 174 participants | Very low Downgraded: risk of bias, imprecision, indirectness |
Antenatal parasitaemia | RR 0.38 [0.24, 0.59] | 4 studies · 2832 participants | High |
Severe adverse effects13 | no estimate extracted | 0 studies · 0 participants | Ungraded |
Summary of findings table 8
Population: Pregnant women (parity 0‐1)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Spontaneous abortion | RR 0.61 [0.38, 0.99] | 3 studies · 2567 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Stillbirth | RR 0.97 [0.64, 1.47] | 3 studies · 2703 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Perinatal mortality | RR 0.78 [0.52, 1.17] | 1 study · 1237 participants | Low Downgraded: imprecision |
Neonatal mortality | RR 0.62 [0.37, 1.05] | 2 studies · 2156 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Preterm birth | RR 0.85 [0.66, 1.1] | 2 studies · 1493 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Low birthweight | RR 0.81 [0.67, 0.99] | 4 studies · 3043 participants | Moderate Downgraded: risk of bias, indirectness |
Mean birthweight | no estimate extracted | 3 studies · 2127 participants | Moderate Downgraded: risk of bias, indirectness |
Placental parasitaemia | RR 0.45 [0.33, 0.61] | 3 studies · 1633 participants | Moderate Downgraded: risk of bias, inconsistency |
Cord blood haemoglobin | no estimate extracted | 0 studies · 0 participants | Ungraded |