Although earlier studies showed that intermittent preventive therapy in pregnancy (IPTp) with sulfadoxine-pyrimethamine provides substantial benefit to pregnant women and their infants, the spread of resistance raises questions about how long the therapy is efficient for.1 In their meta-analysis, Thomas Eisele and colleagues2 show that IPTp with sulfadoxine-pyrimethamine continues to provide substantial benefits, resulting in a 26% reduction in low birthweight and a 16% reduction in neonatal mortality under programme conditions. However, the absence of exact birthweight data in many of the surveys is an important limitation. Mothers tend to overestimate weight; therefore, the prevalence of low birthweight is underestimated.3 The effect of IPTp with sulfadoxine-pyrimethamine and insecticide-treated nets (ITNs) on low birthweight can be underestimated when mothers' perception of weight is used as a proxy for measured birthweight. Despite this limitation, the study shows how useful birthweight data from cross-sectional surveys are to monitor effectiveness of interventions nationally, and emphasises the importance of obtaining accurate birthweight information on all infants.
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