Effect of Daily Antenatal Iron Supplementation on<i>Plasmodium</i>Infection in Kenyan Women

Mwangi, Martin N; Roth, Johanna; Smit, Menno R; Trijsburg, Laura; Mwangi, Alice; Demir, Ayşe; Wielders, Jos P.M.; Mens, Pètra F.; Verweij, Jaco J.; Cox, Sharon E.; Prentice, Andrew M.; Brouwer, Inge D.; Savelkoul, H.F.J.; Andang’o, Pauline; Verhoef, Hans

doi:10.1001/jama.2015.9496

Cited by 72 publications

(84 citation statements)

References 28 publications

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“…By contrast, the risk of Plasmodium infection at delivery was high in the Kenyan trial (Mwangi et al , 2015) (50·9% vs. 52·1% in the iron and placebo groups, respectively), and the upper limit of 95% CI of the effect of iron excluded an increase in the risk of Plasmodium infection beyond 9·5%. Iron deficiency was highly prevalent in the study population (60% prevalence at baseline), whilst few women (16%) possessed insecticide‐impregnated mosquito nets.…”

Section: Safety Of Antenatal Iron Interventions In Malaria‐endemic Sementioning

confidence: 91%

“…Two well‐conducted randomised trials (Etheredge et al , 2015; Mwangi et al , 2015) were published after these systematic reviews. Table 2 compares the key c haracteristics and findings from these trials.…”

Section: Safety Of Antenatal Iron Interventions In Malaria‐endemic Sementioning

confidence: 99%

“…aIntermittent preventive treatment with sulfadoxine‐pyrimethamine.bPrimary outcome, defined by histopathological examination and polymerase chain reaction (PCR) analysis of placental biopsies (Etheredge et al , 2015) or 1 or more positive results for (i) the presence of parasite lactate dehydrogenase (pLDH) or histidine‐rich protein II (HRP2) in plasma, or (ii) by placental histopathology, or (iii) P. falciparum DNA in maternal erythrocytes from venous or placental blood by PCR test (Mwangi et al , 2015). …”

Section: Safety Of Antenatal Iron Interventions In Malaria‐endemic Sementioning

confidence: 99%

“…To our knowledge, the study in Kenyan women cited previously (Mwangi et al , 2015) is the only placebo‐controlled trial conducted so far that enrolled women with iron deficiency and anaemia at baseline. In that trial, antenatal iron supplementation increased birth weight by 150 g (95% CI: 56–244 g).…”

Section: Benefits Of Antenatal Iron Interventionsmentioning

confidence: 99%

“…Additional results indicated that the improvements in birth weight were achieved at least in part through an increased gestational duration, a decreased risk of prematurity and an increased neonatal length (Mwangi et al , 2015). Lastly, antenatal iron supplementation improved neonatal iron stores at 1 month postpartum, thus probably delaying the age at which iron deficiency will develop during infancy.…”

Section: Benefits Of Antenatal Iron Interventionsmentioning

confidence: 99%

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Safety and benefits of antenatal oral iron supplementation in low‐income countries: a review

2017

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SummaryThe World Health Organization recommends universal iron supplementation of 30–60 mg/day in pregnancy but coverage is low in most countries. Its efficacy is uncertain, however, and there has been a vigorous debate in the last decade about its safety, particularly in areas with a high burden of malaria and other infectious diseases. We reviewed the evidence on the safety and efficacy of antenatal iron supplementation in low‐income countries. We found no evidence that daily supplementation at a dose of 60 mg leads to increased maternal Plasmodium infection risk. On the other hand, recent meta‐analyses found that antenatal iron supplementation provides benefits for maternal health (severe anaemia at postpartum, blood transfusion). For neonates, there was a reduced prematurity risk, and only a small or no effect on birth weight. A recent trial showed, however, that benefits of antenatal iron supplementation on maternal and neonatal health vary by maternal iron status, with substantial benefits in iron‐deficient women. The benefits of universal iron supplementation are likely to vary with the prevalence of iron deficiency. As a consequence, the balance between benefits and risks is probably more favourable in low‐income countries than in high‐income countries despite the higher exposure to infectious pathogens.

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Section: Safety Of Antenatal Iron Interventions In Malaria‐endemic Sementioning

confidence: 91%

Section: Safety Of Antenatal Iron Interventions In Malaria‐endemic Sementioning

confidence: 99%