A systematic review of the safety and efficacy of artemether-lumefantrine against uncomplicated Plasmodium falciparum malaria during pregnancy

Table 2 Pregnancy outcomes of artemether and lumefantrine use during pregnancy

Publication	Drug (n)	Trimester		Pregnancy outcomes
Publication	Drug (n)	1	2/3	Prematurity	Miscarriage	Stillbirth	Congenital abnormality	Low birth weight	Neo-natal death
Wang 1989[20]	A	0	2	0/2			0/2^a
Sowunmi *et al.,* 1998[15]	A + MQ (22), A (23)	0	45
McGready *et al.* , 2001[17]	A + MQ/AS/C (10), AL (1)	–	–		1/9
Adam *et al.,* 2004[16]	A	1	27	1/28^b			0/28
McGready *et al.,* 2006[21]	AL	0	13*	1^c			0
McGready *et al.* , 2008[22]	AL	0	125	3/117 (2.6%)	0/125	1/125 (0.8%)	3/117 (2.6%)	14/99 (14.1%)
McGready *et al.* , 2008[22]	AS	0	128	10/120 (8.3%)	1/128 (0.8%)	1/128 (0.8%)	4/120 (3.3%)	20/101 (19.8%)
Kaye *et al.* , 2008[23]	AL	0	58
Adam *et al.,* 2009[24]	A (48), AL (3)	51	0		2^d		0
Piola *et al.* , 2010[25]	AL	0	152	12/143 (8.4%)	3/144 (2.1%)	2/144 (1.4%)	3/143 (2.1%)	12/120 (10.2%)	3/144 (2.1%)
Piola *et al.* , 2010[25]	Q	0	152	17/137 (12.4%)	4/137 (2.9%)	3/137 (2.2%)	2/137 (1.5%)	16/119 (13.4%)	6/137 (4.4%)
Manyando *et al.* , 2010[26]	AL^e	156	348	71/504 (14.1%)	7/504 (1.4%)	9/504 (1.8%)	8/449 (1.8%) (29/449 [6.5%])^f	9.0%	11/475 (2.3%)
	AL 1^st trimester	156		20/150 (13.3%)	7/159 (4.4%)^g	2/135 (1.5%)	1/130 (0.8%) (9/130 [6.9%])^f		4/135 (3%)
	SP/Q^e	138	378	90/516 (17.4%)	8/516 (1.6%)	13/516 (2.5%)	SP 6/444 (1.4%) (18/444 [4.1%])^f	7.7%	11/480 (2.3%)
	SP/Q 1^st trimester	138		28/135 (20.7%)	0/135	3/129 (2.3%)	3/121 (2.5%) (8/121 [6.6%])^f		2/129 (1.6%)
Sangaré *et al.,* 2011[27]	AL (260)^h	53ⁱ	207			7/500^j

A artemether; AL artemether-lumefantrine; AS artesunate; C clindamycin; MQ mefloquine; Q quinine; SP sulphadoxine-pyrimethamine; *These 13 exposures are not included in the total count of exposures to AL in pregnant women as they were also included in McGready et al., 2008 [22]; ^a5 years; ^binfant died, 2^nd–3^rd trimester exposure; ^cassociated with maternal urinary tract infection; ^dA group, associated with quinine infusion for further malaria attack; ^eAL group n = 495, AL exposure 504, SP group n = 506, SP/Q exposure n = 516; ^fincluding umbilical hernia; ^g2 multiple malaria episodes, 1 syphilis, 1 concomitant salbutamol and AL for threatened abortion; ^h260 reports of AL treatment for an episode of malaria; ⁱ26 received only AL in the 1st trimester; ^jtotal study population.

ISSN: 1475-2875