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Demographics and health practices of 2,232 pregnant women in rural northeastern Ghana and characteristics of their 2,279 newborns were analyzed to determine benefits associated with intermittent preventive treatment (IPTp), antenatal care, and/or bed net use during pregnancy. More than half reported bed net use, 90% reported at least two antenatal care visits, and > 82% took at least one IPTp dose of sulfadoxine-pyrimethamine. Most used a bed net and IPTp (45%) or IPTp alone (38%). Low birth weight (< 2,500 grams) characterized 18.3% of the newborns and was significantly associated with female sex, Nankam ethnicity, first-born status, and multiple births. Among newborns of primigravidae, IPTp was associated with a significantly greater birth weight, significantly fewer low birth weight newborns, improved hemoglobin levels, and less anemia. Babies of multigravidae derived no benefit to birth weight or hemoglobin level from single or multiple doses of sulfadoxine-pyrimethamine during pregnancy. No differences or benefits were seen when a bed net was the only protective factor.
Financial support: This study was supported by National Institutes of Health Division of Microbiology and Infectious Diseases Contract #HHSN266200400016C and interagency agreement #Y1-AI-4866.
Authors' addresses: Abraham R. Oduro, Francis Anto, Frank Atuguba, Thomas Anyorigiya, Martin Adjuik, Patrick Ansah, and Abraham Hodgson, Navrongo Health Research Center, Navrongo, Ghana. David J. Fryauff and William O. Rogers, Naval Medical Research Center, Silver Spring, MD, E-mail: email@example.com. Kwadwo A. Koram and Francis Nkrumah, Noguchi Memorial Institute for Medical Research, Accra, Ghana.