Malaria early in the first pregnancy: Potential impact of iron status

Low iron stores may protect from malaria infection, therefore improving iron stores in early pregnancy in line with current recommendations could increase malaria susceptibility. To test this hypothesis we compared iron biomarkers and red cell indices in nulliparae and primigravidae who participated...

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Published in:Clinical nutrition (Edinburgh, Scotland) Scotland), 2020-01, Vol.39 (1), p.204-214
Main Authors: Diallo, Salou, Roberts, Stephen A., Gies, Sabine, Rouamba, Toussaint, Swinkels, Dorine W., Geurts-Moespot, Anneke J., Ouedraogo, Sayouba, Ouedraogo, Georges Anicet, Tinto, Halidou, Brabin, Bernard J.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Anemia, Iron-Deficiency - blood
Anemia, Iron-Deficiency - epidemiology
Biomarkers
Burkina Faso - epidemiology
Cross-Sectional Studies
Female
Gravidity
Humans
Inflammation
Iron - blood
Iron biomarkers
Longitudinal Studies
Malaria
Malaria - blood
Malaria - epidemiology
Non-pregnant
Pregnancy
Pregnancy Trimester, First
Pregnant
Prevalence
Young Adult
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Summary:Low iron stores may protect from malaria infection, therefore improving iron stores in early pregnancy in line with current recommendations could increase malaria susceptibility. To test this hypothesis we compared iron biomarkers and red cell indices in nulliparae and primigravidae who participated in a randomized controlled trial of long-term weekly iron supplementation. Cross-sectional and longitudinal data analysis from a randomized controlled trial of long-term weekly iron supplementation in rural Burkina Faso. Malaria parasitaemia was monitored and biomarkers and red cell indices measured at study end-points: plasma ferritin, transferrin receptor (sTfR), zinc protoporphyrin, hepcidin, sTfR/log10 ferritin ratio, body iron, haemoglobin, red cell distribution width; mean corpuscular haemoglobin concentration/volume, and C-reactive protein. Correlation coefficients between biomarkers and red cell indices were determined. A regression correction approach based on ferritin was used to estimate iron body stores, allowing for inflammation. Body iron differences were compared between nulliparae and primigravidae, and the association determined of iron biomarkers and body iron stores with malaria. Iron and haematological indices of 972 nulliparae (mean age 16.5 years) and 314 primigravidae (median gestation 18 weeks) were available. Malaria prevalence was 54.0% in primigravidae and 41.8% in nulliparae (relative risk 1.28, 95% CI 1.13–1.45, P 
ISSN:0261-5614
1532-1983
DOI:10.1016/j.clnu.2019.01.016