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Comparison 1 Insecticide‐treated nets versus no nets, Outcome 1 Severe anaemia.
Figures and Tables -
Analysis 1.1

Comparison 1 Insecticide‐treated nets versus no nets, Outcome 1 Severe anaemia.

Comparison 1 Insecticide‐treated nets versus no nets, Outcome 2 Any anaemia.
Figures and Tables -
Analysis 1.2

Comparison 1 Insecticide‐treated nets versus no nets, Outcome 2 Any anaemia.

Comparison 1 Insecticide‐treated nets versus no nets, Outcome 3 Haemoglobin (g/L).
Figures and Tables -
Analysis 1.3

Comparison 1 Insecticide‐treated nets versus no nets, Outcome 3 Haemoglobin (g/L).

Comparison 1 Insecticide‐treated nets versus no nets, Outcome 4 Low birthweight.
Figures and Tables -
Analysis 1.4

Comparison 1 Insecticide‐treated nets versus no nets, Outcome 4 Low birthweight.

Comparison 1 Insecticide‐treated nets versus no nets, Outcome 5 Birthweight (kg).
Figures and Tables -
Analysis 1.5

Comparison 1 Insecticide‐treated nets versus no nets, Outcome 5 Birthweight (kg).

Comparison 1 Insecticide‐treated nets versus no nets, Outcome 6 Clinical malaria illness during pregnancy.
Figures and Tables -
Analysis 1.6

Comparison 1 Insecticide‐treated nets versus no nets, Outcome 6 Clinical malaria illness during pregnancy.

Comparison 1 Insecticide‐treated nets versus no nets, Outcome 7 Peripheral parasitaemia.
Figures and Tables -
Analysis 1.7

Comparison 1 Insecticide‐treated nets versus no nets, Outcome 7 Peripheral parasitaemia.

Comparison 1 Insecticide‐treated nets versus no nets, Outcome 8 Parasite density.
Figures and Tables -
Analysis 1.8

Comparison 1 Insecticide‐treated nets versus no nets, Outcome 8 Parasite density.

Comparison 1 Insecticide‐treated nets versus no nets, Outcome 9 Placental parasitaemia.
Figures and Tables -
Analysis 1.9

Comparison 1 Insecticide‐treated nets versus no nets, Outcome 9 Placental parasitaemia.

Comparison 1 Insecticide‐treated nets versus no nets, Outcome 10 Fetal loss.
Figures and Tables -
Analysis 1.10

Comparison 1 Insecticide‐treated nets versus no nets, Outcome 10 Fetal loss.

Table 1. Detailed search strategies

Search set

CIDG SRa

CENTRAL

MEDLINEb

EMBASEb

LILACSb

1

malaria

malaria

malaria

malaria

malaria

2

pregnan*

pregnan*

pregnan*

pregnan*

pregnan*

3

woman

woman

woman

woman

woman

4

women

women

women

women

women

5

3 or 4

3 or 4

3 or 4

3 or 4

3 or 4

6

1 and 2 and 5

1 and 2 and 5

1 and 2 and 5

1 and 2 and 5

1 and 2 and 5

7

net*

net*

net*

net*

net*

8

ITN*

ITN*

ITN*

ITN*

6 and 7

9

ITM*

ITM*

ITM*

ITM*

10

7 or 8 or 9

7 or 8 or 9

7 or 8 or 9

7 or 8 or 9

11

6 and 10

6 and 10

6 and 10

6 and 10

aCochrane Infectious Diseases Group Specialized Register.
bSearch terms used in combination with the search strategy for retrieving trials developed by The Cochrane Collaboration (Higgins 2005); upper case: MeSH or EMTREE heading; lower case: free text term.

Figures and Tables -
Table 1. Detailed search strategies
Table 2. Risk of bias assessmenta

Trial

Generation of allocation sequence

Allocation concealment

Blinding

Inclusion of all randomized participants in the analysis

Dolan 1993

Method not described

Not described

Double blind (participants, antenatal clinic staff, and supervising physician) for ITNs versus untreated nets comparison

Adequate

Shulman 1998

Adequate

Adequate

Open

Adequate for number with a third trimester blood sample

Inadequate for number women who delivered in hospital

Adequate for number followed up at least 4 weeks after delivery

Adequate for number with a third trimester blood sample

Inadequate for number women who delivered in hospital

Adequate for number followed up at least 4 weeks after delivery

Browne 2001

Adequate

Adequate

Open

Adequate for number with blood taken in third trimester for malaria and haemoglobin

Inadequate for number with pregnancy outcomes reported

Njagi 2002

Adequate

Not described

Open for ITNs versus no nets comparison

Double blind for sulfadoxine‐pyrimethamine (SP) versus SP placebo comparison

Open for ITNs versus no nets comparison

Double blind for sulfadoxine‐pyrimethamine (SP) versus SP placebo comparison

Inadequate for number evaluated at delivery

ter Kuile 2003

Adequate

Adequate

Open

Adequate number for birth outcomes and analysis of outcomes assessing the impact of nets during pregnancy

aDetails of methods used in individual trials are in the 'Characteristics of included studies'.

Figures and Tables -
Table 2. Risk of bias assessmenta
Comparison 1. Insecticide‐treated nets versus no nets

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Severe anaemia Show forest plot

4

Various (Fixed, 95% CI)

Subtotals only

1.1 Odds ratio (third trimester)

2

Various (Fixed, 95% CI)

0.77 [0.56, 1.08]

1.2 Risk ratio (at delivery)

2

Various (Fixed, 95% CI)

0.98 [0.63, 1.52]

1.3 Hazard ratio

2

Various (Fixed, 95% CI)

0.89 [0.61, 1.31]

2 Any anaemia Show forest plot

5

Various (Random, 95% CI)

Subtotals only

2.1 Odds ratio (third trimester)

1

Various (Random, 95% CI)

0.88 [0.71, 1.10]

2.2 Odds ratio (at delivery)

2

Various (Random, 95% CI)

0.95 [0.50, 1.79]

2.3 Hazard ratio

2

Various (Random, 95% CI)

0.90 [0.71, 1.13]

3 Haemoglobin (g/L) Show forest plot

11

Mean difference (Random, 95% CI)

Subtotals only

3.1 Third trimester: first or second pregnancy

5

Mean difference (Random, 95% CI)

‐0.04 [‐2.41, 2.33]

3.2 Third trimester: third or greater pregnancy

3

Mean difference (Random, 95% CI)

0.30 [‐3.38, 3.97]

3.3 At delivery: first or second pregnancy

3

Mean difference (Random, 95% CI)

1.95 [‐2.61, 6.51]

4 Low birthweight Show forest plot

4

Various (Fixed, 95% CI)

0.80 [0.64, 1.00]

4.1 Risk ratio: first or second pregnancy

3

Various (Fixed, 95% CI)

0.77 [0.61, 0.98]

4.2 Risk ratio: fifth or greater pregnancy

1

Various (Fixed, 95% CI)

1.12 [0.56, 2.24]

5 Birthweight (kg) Show forest plot

10

Mean difference (Fixed, 95% CI)

0.06 [0.02, 0.09]

5.1 First or second pregnancy

8

Mean difference (Fixed, 95% CI)

0.05 [0.02, 0.09]

5.2 Third or greater pregnancy

2

Mean difference (Fixed, 95% CI)

0.08 [‐0.13, 0.28]

6 Clinical malaria illness during pregnancy Show forest plot

2

Various (Fixed, 95% CI)

Totals not selected

6.1 Odds ratio

1

Various (Fixed, 95% CI)

0.0 [0.0, 0.0]

6.2 Hazard ratio

1

Various (Fixed, 95% CI)

0.0 [0.0, 0.0]

7 Peripheral parasitaemia Show forest plot

6

Various (Fixed, 95% CI)

Subtotals only

7.1 Odds ratio: third trimester

2

Various (Fixed, 95% CI)

0.88 [0.73, 1.06]

7.2 Risk ratio: at delivery

4

Various (Fixed, 95% CI)

0.76 [0.67, 0.86]

7.3 Hazard ratio

2

Various (Fixed, 95% CI)

0.67 [0.52, 0.86]

8 Parasite density Show forest plot

8

Geometric mean ratio (Fixed, 95% CI)

0.93 [0.77, 1.11]

8.1 First or second pregnancy

6

Geometric mean ratio (Fixed, 95% CI)

0.82 [0.66, 1.02]

8.2 Third or greater pregnancy

2

Geometric mean ratio (Fixed, 95% CI)

1.28 [0.90, 1.82]

9 Placental parasitaemia Show forest plot

5

Risk Ratio (Random, 95% CI)

0.79 [0.63, 0.98]

9.1 First or second pregnancy

4

Risk Ratio (Random, 95% CI)

0.82 [0.61, 1.11]

9.2 Fifth or greater pregnancy

1

Risk Ratio (Random, 95% CI)

0.72 [0.48, 1.08]

10 Fetal loss Show forest plot

5

Risk Ratio (Fixed, 95% CI)

0.68 [0.48, 0.98]

10.1 First or second pregnancy

4

Risk Ratio (Fixed, 95% CI)

0.67 [0.47, 0.97]

10.2 Fifth or greater pregnancy

1

Risk Ratio (Fixed, 95% CI)

1.02 [0.17, 6.23]

Figures and Tables -
Comparison 1. Insecticide‐treated nets versus no nets