Evidence map›Paper›PMID 30783215›Full record

Trial reportScientific reports2019

Sulphadoxine-pyrimethamine plus azithromycin may improve birth outcomes through impacts on inflammation and placental angiogenesis independent of malarial infection.

Holger W Unger, Annjaleen P Hansa, Christelle Buffet, Wina Hasang, Andrew Teo, Louise Randall, Maria Ome-Kaius, Stephan Karl, Ayen A Anuan, James G Beeson and 3 more

Open access · goldAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Scientific reports, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed, 1 pooled it
2.4field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

22 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Trial
  4. Trial
  5. Trial
  6. Trial
  7. Article
  8. Article
  9. Review
  10. Review
  11. Article
  12. Review
  13. Article
  14. Article
  15. Review
  16. Review
  17. Article
  18. Article
  19. Review
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 4 institutions in 4 countries.

Holger W UngerDepartment of Medicine at the Doherty Institute, University of Melbourne, Parkville, Victoria, Australia. hwunger@doctors.org.uk.
Annjaleen P HansaDepartment of Medicine at the Doherty Institute, University of Melbourne, Parkville, Victoria, Australia.
Christelle BuffetDepartment of Medicine at the Doherty Institute, University of Melbourne, Parkville, Victoria, Australia.
Wina HasangDepartment of Medicine at the Doherty Institute, University of Melbourne, Parkville, Victoria, Australia.
Andrew TeoDepartment of Medicine at the Doherty Institute, University of Melbourne, Parkville, Victoria, Australia.
Louise RandallDepartment of Medicine at the Doherty Institute, University of Melbourne, Parkville, Victoria, Australia.
Maria Ome-KaiusPapua New Guinea Institute of Medical Research, Goroka, Papua New Guinea.
Stephan KarlPapua New Guinea Institute of Medical Research, Goroka, Papua New Guinea.
Ayen A AnuanDepartment of Medicine at the Doherty Institute, University of Melbourne, Parkville, Victoria, Australia.
James G BeesonDepartment of Medicine at the Doherty Institute, University of Melbourne, Parkville, Victoria, Australia.
Ivo MuellerWalter and Eliza Hall Institute, Parkville, Victoria, Australia.
Sarah J StockTommy's Centre for Maternal and Fetal Health, MRC Centre for Reproductive Health, Queen's Medical Research Institute, Edinburgh, UK.ORCID 0000-0003-4308-856X
Stephen J RogersonDepartment of Medicine at the Doherty Institute, University of Melbourne, Parkville, Victoria, Australia.ORCID 0000-0003-4287-1982
The University of Melbourne · AUBurnet Institute · AUInstitut Pasteur · FRMRC Centre for Reproductive Health · GB

Funding

Wellcome TrustWellcome Trust 209560/Z/17/Z
6 · The paper itself

Abstract

Intermittent preventive treatment with sulphadoxine-pyrimethamine (SP) and SP plus azithromycin (SPAZ) reduces low birthweight (<2,500 g) in women without malarial and reproductive tract infections. This study investigates the impact of SPAZ on associations between plasma biomarkers of inflammation and angiogenesis and adverse pregnancy outcomes in 2,012 Papua New Guinean women. Concentrations of C-reactive protein (CRP), α-1-acid glycoprotein (AGP), soluble endoglin (sEng), soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) were measured at enrolment and delivery in a trial comparing SPAZ to SP plus chloroquine (SPCQ). At antenatal enrolment higher CRP (adjusted odds ratio 1.52; 95% confidence interval [CI] 1.03-2.25), sEng (4.35; 1.77, 10.7) and sFlt1 (2.21; 1.09, 4.48) were associated with preterm birth, and higher sEng with low birthweight (1.39; 1.11,3.37), in SPCQ recipients only. Increased enrolment sFlt1:PlGF ratios associated with LBW in all women (1.46; 1.11, 1.90). At delivery, higher AGP levels were strongly associated with low birthweight, preterm birth and small-for-gestational age babies in the SPCQ arm only. Restricting analyses to women without malaria infection did not materially alter these relationships. Women receiving SPAZ had lower delivery AGP and CRP levels (p < 0.001). SPAZ may protect against adverse pregnancy outcomes by reducing inflammation and preventing its deleterious consequences, including dysregulation of placental angiogenesis, in women with and without malarial infection.

Indexed as

Live BirthMalariaPlacentaPregnancy Complications, ParasiticAzithromycinBiomarkersDrug CombinationsFemaleHumansInfant, NewbornNeovascularization, PhysiologicPapua New GuineaPregnancyPyrimethamineSulfadoxineAzithromycinBiomarkersDrug Combinationsfanasil, pyrimethamine drug combinationPyrimethamineSulfadoxine

Identifiers

PMID30783215
PMCPMC6381158
OpenAlexW2913986089

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.