***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Maternal schistosomiasis and filariasis have been shown to influence infant responses to neonatal bacille Calmette-Guérin ( BCG ) immunisation but the effects of maternal hookworm , and of de-worming in pregnancy , are unknown . Methods In Entebbe , Ug and a , we conducted a r and omised , double-blind , placebo-controlled trial of a single dose of 400 mg of albendazole in the second trimester of pregnancy . Neonates received BCG .  Interferon-gamma ( IFN-γ ) and interleukin (IL)-5 responses to a mycobacterial antigen ( crude culture filtrate proteins ( CFP ) of Mycobacterium tuberculosis ) were measured in a whole blood assay . We analysed results for binary variables using χ2 tests and logistic regression . We analysed continuous variables using Wilcoxon 's tests . Results Maternal hookworm was associated with reduced maternal IFN-γ responses to CFP ( adjusted odds ratio for IFN-γ > median response : 0.14 ( 95 % confidence interval 0.02–0.83 , p = 0.021 ) . Conversely , maternal hookworm was associated with subsequent increased IFN-γ responses in their one-year-old infants ( adjusted OR 17.65 ( 1.20–258.66 ; p = 0.013 ) ) . Maternal albendazole tended to reduce these effects . Conclusion Untreated hookworm infection in pregnancy was associated with reduced maternal IFN-γ responses to mycobacterial antigens , but increased responses in their infants one year after BCG immunisation . The mechanisms of these effects , and their implication s for protective immunity remain , to be determined Objectives To study mortality in African children born to HIV-1-infected mothers exposed peripartum to zidovudine .  Methods A r and omized placebo-controlled trial in Abidjan and Bobo-Dioulasso . Pregnant women received either 300 mg zidovudine twice daily from 36–38 weeks ’ gestation , 600 mg during labour , and 300 mg twice daily for 7 days post-partum or a matching placebo . Determinants of mortality were studied up to 18 months , overall and among the infected children : treatment , centre , timing of infection , mother and child HIV disease . Results There were 75 infant deaths among 407 live births .  The risk of death at 18 months was 176/1000 in the zidovudine arm and 221 for placebo . Relative hazard ( RH , zidovudine versus placebo ) was 0.47 [ 95 % confidence interval ( CI ) 0.2–1.0 ] up to 230 days of life . Maternal CD4 lymphocyte count < 200/mm3 ( RH 2.92 ; CI 1.4–6.1 ) and child HIV-1 infection ( RH 12.6 ; CI 6.6–24.3 ) increased mortality of all children born to HIV-1-infected mothers . There were 101 children infected ( 40 in the zidovudine group ) , and 51 died . Their 18 month probability of death was 590/1000 in the zidovudine group and 510 in the placebo group . Among infected children , maternal zidovudine reduced the risk of death on or before day 230 ( RH 0.18 ; CI 0.1–0.5 ) . Maternal CD4 lymphocyte count < 200/mm3 ( RH 3.25 ; CI 1.3–8.4 ) , maternal death ( RH 9.65 ; CI 1.7–56.0 ) , diagnosis of paediatric infection on or before day 12 ( RH 18.1 ; CI 4.8–69.0 ) and between days 13 and 45 ( RH 7.63 ; CI 2.0–29.5 ) , clinical paediatric AIDS ( RH 5.37 ; CI 2.3–12.7 ) were risk factors for death in HIV-1-infected children . Conclusion Mother-to-child transmission reduction by zidovudine is safe and beneficial to African children . The mortality of HIV-1-infected children is high . Peripartum maternal zidovudine exerts a protective effect for at least 8 months BACKGROUND Maternal periodontal disease has been associated with an increased risk of  preterm birth and low birth weight .  We studied the effect of nonsurgical periodontal treatment on preterm birth . METHODS We r and omly assigned women between 13 and 17 weeks of gestation to undergo  scaling and root planing either before 21 weeks ( 413 patients in the treatment group ) or after delivery ( 410 patients in the control group ) . Patients in the treatment group also underwent monthly tooth polishing and received instruction in oral hygiene . The gestational age at the end of pregnancy was the prespecified primary outcome . Secondary outcomes were birth weight and the proportion of infants who were small for gestational age . RESULTS In the follow-up analysis , preterm birth ( before 37 weeks of gestation ) occurred in 49 of 407 women ( 12.0 % ) in the treatment group ( result ing in 44 live births ) and in 52 of 405 women ( 12.8 % ) in the control group ( result ing in 38 live births ) . Although periodontal treatment improved periodontitis measures ( P<0.001 ) , it did not significantly alter the risk of preterm delivery ( P=0.70 ; hazard ratio for treatment group vs. control group , 0.93 ; 95 % confidence interval [ CI ] , 0.63 to 1.37 ) . There were no significant differences between the treatment and control groups in birth weight ( 3239 g vs. 3258 g , P=0.64 ) or in the rate of delivery of infants that were small for gestational age ( 12.7 % vs. 12.3 % ; odds ratio , 1.04 ; 95 % CI , 0.68 to 1.58 ) . There were 5 spontaneous abortions or stillbirths in the treatment group , as compared with 14 in the control group ( P=0.08 ) . CONCLUSIONS Treatment  of periodontitis in pregnant women improves periodontal disease and is safe but does not significantly alter rates of preterm birth , low birth weight , or fetal growth restriction . ( Clinical Trials.gov number , NCT00066131 [ Clinical Trials.gov ] . ) Objective This study aim ed to investigate a relationship between maternal periodontal disease and preterm birth , low birth weight and late miscarriage .  Design Prospect i ve study in a single centre . Setting Guy 's and St Thomas ' Hospital Trust , London , UK between August 1998 and July 2001.Subjects and Methods Pregnant women were recruited on attending an ultrasound scan at approximately 12 weeks of pregnancy . Subjects completed a question naire and underwent periodontal examination . Main outcome measures Plaque and bleeding scores , pocket probing depth and loss of attachment . Pregnancy outcome data was collected retrospectively , including gestational age and birth weight at delivery . Results Data were collected for 3,738 subjects . Regression analysis indicated that there were no significant relationships between the severity of periodontal disease and either preterm birth ( PTB ) or low birth weight ( LBW ) . In contrast , there did appear to be a correlation between poorer periodontal health and those that experienced a late miscarriage . Conclusions There was no association between either preterm birth or low birth weight and periodontal disease in this population . There is evidence of a correlation between markers of poorer periodontal health and late miscarriage OBJECTIVE To assess the ability of clindamycin vaginal cream to reduce the incidence of preterm birth in women with abnormal genital tract flora in the second trimester of pregnancy . METHODS This was a r and omized , double-blind , placebo-controlled , tricenter study . A total of 409 women with abnormal genital tract flora on Gram stain of vaginal secretions at 13–20 weeks ' gestation were r and omized to receive a 3-day course of clindamycin vaginal cream or placebo . Those women who still had abnormal vaginal flora 3 weeks later received a 7-day course of the original study drug ( ie , either clindamycin vaginal cream or placebo as per original r and omization ) . The primary outcome measure was the incidence of preterm birth . RESULTS There was a statistically significant reduction in the incidence of preterm birth in the clindamycin vaginal cream group ( 4 % ) compared with placebo ( 10 % ) ( P < .03 ) . Significantly more babies born preterm ( 63 % ) required admission to the neonatal intensive care unit compared with term infants ( 4 % ) ( P < .001 ) . CONCLUSION A 2 % clindamycin vaginal cream , when compared with placebo administered to women with abnormal genital tract flora before 20 weeks ' gestation , can reduce the incidence of preterm birth by 60 % and hence the need for neonatal intensive care BACKGROUND In areas of endemic transmission , malaria in pregnancy is associated with severe maternal anaemia and low-birthweight babies . We studied the efficacy of intermittent treatment doses of sulphadoxine-pyrimethamine in preventing malaria and severe anaemia in pregnancy in a double-blind placebo-controlled trial among primigravid women living in Kilifi District , Kenya . METHODS Between January , 1996 , and April , 1997 , 1264 primigravid women were recruited when they attended for antenatal care , and r and omly assigned sulphadoxine-pyrimethamine ( 640 ) or placebo ( 624 ) . Women received one , two , or three doses of study medication depending on the duration of gestation at enrolment . Primary outcome measures were severe anaemia ( haemoglobin < 8 g/dL ) and malaria parasitaemia , assessed at 34 weeks of gestation . Analyses were based on intention to treat among women who had study blood tests at 34 weeks . FINDINGS 30 ( 5.3 % ) of 567 women in the sulphadoxine-pyrimethamine group and 199 ( 35.3 % ) of 564 in the placebo group had peripheral parasitaemia ( protective efficacy 85 % [ 95 % CI 78 - 90 ] , p<0.0001 ) . 82 ( 14.5 % ) and 134 ( 23.7 % ) had severe anaemia ( protective efficacy 39 % [ 22 - 52 ] , p<0.0001 ) . Even women who booked late and received only one dose of sulphadoxine-pyrimethamine benefited significantly from the intervention . The effects were seen both in women who owned insecticide-treated bednets and in women who did not . INTERPRETATION Intermittent presumptive treatment with sulphadoxine-pyrimethamine is an effective , practicable strategy to decrease the risk of severe anaemia in primigravidae living in malarious areas Malarial infection during pregnancy increases the risks of severe sequelae for the pregnant woman and the risk of delivering a low birthweight baby . The aim of this intervention study was to reduce significantly the prevalence of malaria parasitaemia in adolescent parturients in Matola and Boane in Mozambique . The study was focused upon the most malaria-vulnerable group , adolescent nulliparous and primiparous women . After completing the usual antenatal clinic and giving informed consent , 600 pregnant women were r and omly chosen in a double blind manner to one of two regimens comparing the prevailing routine ( placebo ) for malaria prevention with a two dose regimen of sulphadoxine-pyrimethamine ( SP ) . The first dose was given at enrollment with a second dose at the beginning of the third trimester . At delivery maternal and placental malaria parasitaemia as well as birthweight and gestational duration were analysed . At booking the prevalence of malaria parasitaemia was 35.3 % in the placebo group and 30.6 % in the SP group . At the second dose , the prevalence of malaria parasitaemia in the placebo group and SP group was 19.7 % and 8.7 % , respectively . This implies a relative risk ( RR ) of 2.24 with 95 % CI ( 1.34 , 3.75 ) . The corresponding figures at delivery were 13.6 % and 6.3 % with an RR of 2.22 ( 1.07 , 4.60 ) and in placenta 13.3 % and 2.4 % with an RR of 4.87 ( 1.58 , 15.0 ) . Newborns with malaria within 7 days were significantly more frequent in the placebo group , 6.4 % and 0.7 % respectively , with an RR of 6.55 ( 1.20 , 35.7 ) . Almost all ( approximately 98 % ) of the women studied had Plasmodium falciparum , the remainder had P. malariae and P. ovale . The mean birthweight in the SP group was 3077 g and in the placebo group 2926 g. The estimated mean difference between the two groups was 151 g with 95 % CI ( 51 , 252 
    Output:
    
Conclusions The clearest evidence of impact in stillbirth reduction was found for adequate prevention and treatment of syphilis infection and possibly malaria .