First evidence drug used to combat malaria in pregnancy also protects against sexually transmitted infections

A drug given to pregnant women in 35 countries worldwide to protect against malaria has been shown also to safeguard against the consequences of gonorrhoea, chlamydia, trichomoniasis, and bacterial vaginosis, according to a new study published in Clinical Infectious Diseases. 

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The World Health Organization recommends providing intermittent preventive treatment (IPTp) using sulphadoxine-pyrimethamine (SP) to pregnant women living in malaria-endemic areas as part of every scheduled antenatal care visit, from the second trimester until delivery, to reduce adverse birth outcomes caused by malaria infection. This study has produced the first compelling evidence that the same preventive treatment reduces adverse birth outcomes attributable to curable sexually transmitted/reproductive tract infections (STIs/RTIs).

The research, led by the London School of Hygiene & Tropical Medicine with partners the University of Zambia, involved 1,086 pregnant women in Zambia. Researchers investigated the protective effect that different doses of IPTp-SP had on pregnancy outcomes. The analyses confirmed IPTp-SP protects against adverse birth outcomes but of particular interest to the team was the effect the drug had on the infections themselves. At delivery, women who experienced an adverse birth outcome who had had two or more doses of IPTp-SP compared to 0-1 dose were 76% less likely to have a malaria infection, 94% less likely to have gonorrhoea or chlamydia, and 66% less likely to have trichomoniasis or bacterial vaginosis. 

There are 880,000 stillbirths and 1.2 million newborn deaths each year in sub-Saharan Africa, many of which are linked to maternal infection. A 2012 School study found that nearly 4 of every 10 women at health facilities have a malaria infection.  An even higher number of women, if added together, are infected with the STIs/RTIs syphilis, gonorrhoea, chlamydia, tichomononiasis and bacterial vaginosis.

Lead author of this new study, Assistant Professor Matthew Chico from the London School of Hygiene & Tropical Medicine, said: “Sexually transmitted and reproductive tract infections are linked to devastating birth consequences for pregnant women, including spontaneous abortion, stillbirth and premature and low birthweight. While sulfadoxine-pyrimethamine has been thought to offer pregnant women protection against other infections, no evidence existed - until now.  The findings show that IPTp-SP offers unrecognised potential that extends beyond its life-saving protection against malaria.” - See more here

News credit:

Matthew Chico, Enesia Banda Chaponda, Cono Ariti, Daniel Chandramohan. Sulfadoxine-Pyrimethamine Exhibits Dose-Response Protection Against Adverse Birth Outcomes Related to Sexually Transmitted and Reproductive Tract Infections. Clinical Infectious Diseases. DOI:10.1093/cid/cix026