Maternal outcomes
Placental malaria by histology
After two histological studies without placental malaria by histology data were excluded, 2255 were randomized to receive DP, 1757 were randomized to receive SP. The fixed effects analysis showed a significant reduction in DP group compared with SP(RR=0.51; 95%CI, 0.44–0.59; P = 0.19; I²=40.30%; Figure S6; see Supplementary Material), a significant 50% reduction in IPT-DP-8w, 54% reduction in IPT-DP-4-6w(RR=0.50; 95%CI, 0.43–0.59; P = 0.00; I²=0.20%; Figure 9).
Infection with malaria parasites at delivery
The incidence of infection with malaria parasites at delivery was assessed in two trials, 585 participants were included, 497 were randomized to receive DP, 1082 were randomized to receive SP. The fixed effects analysis showed a significant reduction in DP groups(RR=0.05; 95%CI, 0.01–0.23; P = 0.00; I²=0.00%; Figure S7; see Supplementary Material). However, this effect was entirely restricted to a significant 99.96% reduction in IPT- DP-4-6w group (RR=0·04; 95%CI, 0.01–0. 27; P = 0.00; I²=0.00%; Figure 10-A), whereas no treatment effect was found in IPT-DP-8w group yet (0·10 [0·01 to 0·71]; Figure 10-B). Therefore, DP is associated with a better effect with 4-6 weeks of administration.
Anaemia during pregnancy (haemoglobin <110 g/L))
Anaemia during pregnancy was performed in two trials. Since the high degree of heterogeneity (I²= 94.7%), a random effects model was used. The random effect model showed non-significant reduction was found between DP and SP groups (RR=0.71; 95%CI, 0.42–1.22; P = 0.22; Figure S8; see Supplementary Material). The subgroup analysis showed similar effects between IPT-DP-4w, IST-DP and IPT-SP-4-6w groups. (RR=1.07; 95%CI, 0.92–1.24; P = 0.36, I²=0.00%; Figure 11-A) (RR=0.96; 95%CI, 0.85–1.08; P = 0.46; I²=0.00%; Figure 11-B).