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Iron deficiency appears to protect against placental malaria. A study of pregnant Tanzanian women found the prevalence of placental malaria was significantly lower in iron deficient primigravidae than in primigravidae without iron deficiency (8.5 versus 47.3 percent)
Iron plus folate supplementation increases mortality and morbidity among children in areas of malaria endemicity in Africa, but the effects of supplementation on pregnant women in malaria-endemic areas remain unclear. In northeastern Tanzania, where malaria and iron deficiency are common, we found that placental malaria was less prevalent (8.5% vs. 47.3% of women; [Formula: see text]) and less severe (median parasite density, 4.2% vs. 6.3% of placental red blood cells; [Formula: see text]) among women with iron deficiency than among women with sufficient iron stores, especially during the first pregnancy. Multivariate analysis revealed that iron deficiency ([Formula: see text]) and multigravidity ([Formula: see text]) significantly decreased the risk of placental malaria. Interventional trials of iron and folate supplementation during pregnancy in malaria-endemic regions in Africa are urgently needed to ascertain the benefits and risks of this intervention.
1Mother-Offspring Malaria Studies Project, Seattle Biomedical Research Institute, and 2University of Washington, Seattle, Washington; 3Center for International Health Research, Rhode Island Hospital, Brown University, Providence, Rhode Island; and 4Muheza Designated District Hospital, Muheza, 5Tumaini University, Moshi, and 6National Institute for Medical Research, Dar es Salaam, Tanzania.
Iron plus folate supplementation increases mortality and morbidity among children in areas of malaria endemicity in Africa, but the effects of supplementation on pregnant women in malaria-endemic areas remain unclear. In northeastern Tanzania, where malaria and iron deficiency are common, we found that placental malaria was less prevalent (8.5% vs. 47.3% of women; [Formula: see text]) and less severe (median parasite density, 4.2% vs. 6.3% of placental red blood cells; [Formula: see text]) among women with iron deficiency than among women with sufficient iron stores, especially during the first pregnancy. Multivariate analysis revealed that iron deficiency ([Formula: see text]) and multigravidity ([Formula: see text]) significantly decreased the risk of placental malaria. Interventional trials of iron and folate supplementation during pregnancy in malaria-endemic regions in Africa are urgently needed to ascertain the benefits and risks of this intervention.
1Mother-Offspring Malaria Studies Project, Seattle Biomedical Research Institute, and 2University of Washington, Seattle, Washington; 3Center for International Health Research, Rhode Island Hospital, Brown University, Providence, Rhode Island; and 4Muheza Designated District Hospital, Muheza, 5Tumaini University, Moshi, and 6National Institute for Medical Research, Dar es Salaam, Tanzania.
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