 | Bernard Brabin, Sabine Gies, Stephen A Roberts, Salou Diallo, Olga M Lompo, Adama Kazienga, Loretta Brabin, Sayouba Ouedraogo, Halidou Tinto Excess risk of preterm birth with periconceptional iron supplementation in a malaria endemic area: analysis of secondary data on birth outcomes in a double blind randomized controlled safety trial in Burkina Faso (Journal Article) In: Malar. J., vol. 18, no. 1, pp. 161, 2019, ISSN: 1475-2875. @article{Brabin2019-tw,
title = {Excess risk of preterm birth with periconceptional iron supplementation in a malaria endemic area: analysis of secondary data on birth outcomes in a double blind randomized controlled safety trial in Burkina Faso},
author = {Bernard Brabin and Sabine Gies and Stephen A Roberts and Salou Diallo and Olga M Lompo and Adama Kazienga and Loretta Brabin and Sayouba Ouedraogo and Halidou Tinto},
doi = {10.1186/s12936-019-2797-8},
issn = {1475-2875},
year = {2019},
date = {2019-05-01},
urldate = {2019-05-01},
journal = {Malar. J.},
volume = {18},
number = {1},
pages = {161},
publisher = {Springer Science and Business Media LLC},
abstract = {BACKGROUND: Iron supplementation before a first pregnancy may
improve the future health of mother and baby by reducing
maternal anaemia. Iron supplementation could, however, increase
malaria infections, notably in primigravidae who are most
susceptible. The pathogenicity of other iron-utilizing pathogens
could also increase, causing inflammation leading to increased
risk of adverse birth outcomes. This paper reports pre-specified
secondary birth outcomes from a safety trial in Burkina Faso in
an area of high malaria endemicity. Primary outcomes from that
trial had investigated effects of long-term weekly iron
supplementation on malaria and genital tract infections in
non-pregnant and pregnant women. METHODS: A double-blind,
randomized controlled trial. Nulliparous, mainly adolescent
women, were individually randomized periconceptionally to
receive weekly either 60 mg elemental iron and 2.8 mg folic
acid, or 2.8 mg folic acid alone, continuing up to the first
antenatal visit for those becoming pregnant. Secondary outcomes
were ultrasound-dated gestational age, fetal growth, placental
malaria, chorioamnionitis and iron biomarkers. Seasonal effects
were assessed. Analysis was by intention to treat. RESULTS: 478
pregnancies occurred to 1959 women: 258/980 women assigned iron
and folic acid and 220/979 women assigned folic acid alone.
Malaria prevalence at the first antenatal visit was 53% (iron)
and 55% (controls). Mean birthweight was 111 g lower in the iron group (95% CI 9:213},
keywords = {Adolescents; Burkina Faso; Fetal growth; Iron supplements; Malaria; Preterm birth},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: Iron supplementation before a first pregnancy may
improve the future health of mother and baby by reducing
maternal anaemia. Iron supplementation could, however, increase
malaria infections, notably in primigravidae who are most
susceptible. The pathogenicity of other iron-utilizing pathogens
could also increase, causing inflammation leading to increased
risk of adverse birth outcomes. This paper reports pre-specified
secondary birth outcomes from a safety trial in Burkina Faso in
an area of high malaria endemicity. Primary outcomes from that
trial had investigated effects of long-term weekly iron
supplementation on malaria and genital tract infections in
non-pregnant and pregnant women. METHODS: A double-blind,
randomized controlled trial. Nulliparous, mainly adolescent
women, were individually randomized periconceptionally to
receive weekly either 60 mg elemental iron and 2.8 mg folic
acid, or 2.8 mg folic acid alone, continuing up to the first
antenatal visit for those becoming pregnant. Secondary outcomes
were ultrasound-dated gestational age, fetal growth, placental
malaria, chorioamnionitis and iron biomarkers. Seasonal effects
were assessed. Analysis was by intention to treat. RESULTS: 478
pregnancies occurred to 1959 women: 258/980 women assigned iron
and folic acid and 220/979 women assigned folic acid alone.
Malaria prevalence at the first antenatal visit was 53% (iron)
and 55% (controls). Mean birthweight was 111 g lower in the iron group (95% CI 9:213 |
