Research Article Prevalence of Low Birth Weight before and after Policy Change to IPTp-SP in Two Selected Hospitals in Southern Nigeria: Eleven-Year Retrospective Analyses Nneka U. Igboeli , Maxwell O. Adibe , Chinwe V. Ukwe, and Nze C. Aguwa Department of Clinical Pharmacy and Pharmacy Management, Faculty of Pharmaceutical Sciences, University of Nigeria, Nsukka 410001, Nigeria Correspondence should be addressed to Nneka U. Igboeli; nneka.igboeli@unn.edu.ng Received 27 August 2017; Revised 25 November 2017; Accepted 6 December 2017; Published 4 January 2018 Academic Editor: Rana Chattopadhyay Copyright © 2018 Nneka U. Igboeli et al. his is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background. In 2005, Nigeria changed its policy on prevention of malaria in pregnancy to intermittent preventive treatment with sulphadoxine-pyrimethamine (IPTp-SP). Indicators of impact of efective prevention and control of malaria on pregnancy (MIP) are low birth weight (LBW) and maternal anaemia by parity. his study determined the prevalence of LBW for diferent gravidity groups during periods of pre- and postpolicy change to IPTp-SP. Methods. Eleven-year data were abstracted from the delivery registers of two hospitals. Study outcomes calculated for both pre- (2000–2004) and post-IPTp-SP-policy (2005–2010) years were prevalence of LBW for diferent gravidity groups and risk of LBW in primigravidae compared to multigravidae. Results. Out of the 11,496 singleton deliveries recorded within the 11-year period, the prevalence of LBW was signiicantly higher in primigravidae than in multigravidae for both prepolicy (6.3% versus 4%) and postpolicy (8.6% versus 5.1%) years. he risk of LBW in primigravidae compared to multigravidae increased from 1.62 (1.17–2.23) in the prepolicy years to 1.74 (1.436–2.13) during the postpolicy years. Conclusion. he study demonstrated that both the prevalence and risk of LBW remained signiicantly higher in primigravidae even ater the change in policy to IPTp-SP. 1. Introduction Malaria infection during pregnancy is a major public health problem in tropical and subtropical regions of the world. In most endemic areas of the world, pregnancy remains a high- risk factor for malaria infection [1]. Malaria in pregnancy is associated with adverse pregnancy outcomes for both the mother and the fetus. hese include anaemia, parasitaemia, maternal mortality, LBW, prematurity, intrauterine growth retardation (IUGR), abortion, and stillbirth. In areas of high malaria transmission, the risk of low birth weight approximately doubles if women have placental malaria [2], with the greatest efect in primigravidae. LBW can be due to prematurity or IUGR. he relative contribution of IUGR or preterm delivery in causing low birth weight varies by the level of malaria endemicity [3]. he IUGR efect on LBW could be due to histopathological changes of the infected placenta that interferes with nutrient transport. It can also be due to high-density placental parasitaemia with its associated cellular immune responses that lead to the consumption of glucose and oxygen that would have gone to the fetus [4]. Malaria-associated maternal anaemia may also contribute independently to IUGR [4], most likely through a reduction in oxygen transport to the fetus. Prevention of malaria in pregnancy previously consisted of a weekly or bimonthly chemoprophylaxis with chloroquine (CQ) in West African countries and sulphadoxine-pyrimethamine (SP) in East African countries [5]. A large number of trials have demon- strated the eicacy of such a chemoprophylaxis in preventing LBW, maternal anaemia, and placental malaria infection [6, 7]. Unfortunately, because of the growing resistance of parasites to these drugs and poor compliance of pregnant women with the treatment, there is now reduced eicacy with these earlier strategies. In 1998, it was proposed by WHO Hindawi BioMed Research International Volume 2018, Article ID 4658106, 5 pages https://doi.org/10.1155/2018/4658106