(Press-News.org) Among women in a malaria-endemic region in Kenya, daily iron supplementation during pregnancy did not result in an increased risk of malaria, according to a study in the September 8 issue of JAMA. Iron supplementation did result in increased birth weight, gestational duration, neonatal length, and a decreased risk of low birth weight and prematurity.
Anemia in pregnancy is a moderate or severe health problem in more than 80 percent of countries worldwide, but particularly in Africa, where it affects 57 percent of pregnant women. Iron deficiency is the most common cause, but iron supplementation during pregnancy has uncertain health benefits. There is some evidence to suggest that iron supplementation may increase the risk of infectious diseases, including malaria. Martin N. Mwangi, Ph.D., of Wageningen University, Wageningen, the Netherlands, and colleagues randomly assigned 470 pregnant Kenyan women living in a malaria endemic area to daily supplementation with 60 mg of iron (n = 237 women) or placebo (n = 233) until 1 month postpartum. All women received 5.7 mg iron/day through flour fortification during intervention and usual intermittent preventive treatment against malaria.
Among the 470 participating women, 40 women (22 iron, 18 placebo) were lost to follow-up or excluded at birth; 12 mothers were lost to follow-up postpartum (5 iron, 7 placebo). At study entry, 190 of 318 women (60 percent) were iron-deficient. The researchers found that in a comparison of women who received iron vs placebo, Plasmodium infection (malaria) prevalence after childbirth was 50.9 percent vs 52.1 percent. "Overall, we found no effect of daily iron supplementation during pregnancy on risk of maternal Plasmodium infection. Iron supplementation resulted in an increased birth weight [5.3 ounces], gestational duration, and neonatal length; enhanced maternal and infant iron stores at 1 month after birth; and a decreased risk of low birth weight (by 58 percent) and prematurity. The effect on birth weight was influenced by initial maternal iron status. Correction of maternal iron deficiency led to an increase in birth weight by [8.4 ounces]."
Serious adverse events were reported for 9 and 12 women who received iron and placebo, respectively.
The authors note that their results may apply to pregnant women in other low- and middle-income countries, although the effect on birth weight can vary depending on the prevalence of iron deficiency.
"In low- and middle-income countries, it is generally impractical to screen for iron status, and most countries have policies for universal iron supplementation for pregnant women. Based on our results, we believe that the benefits of universal supplementation outweigh possible risks."
(doi:10.1001/jama.2015.9496; Available pre-embargo to the media at http:/media.jamanetwork.com)
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
Editorial: Antenatal Iron Use in Malaria Endemic Settings
"Pregnant women living in areas with endemic malaria require quality antenatal [during pregnancy] care," write Parul Christian, Dr.P.H., M.Sc., and Robert E. Black, M.D., M.P.H., of the Johns Hopkins Bloomberg School of Public Health, Baltimore, in an accompanying editorial.
"In a recent evaluation using Demographic and Health Survey data from 41 countries, among women with 4 or more antenatal care visits, the greatest gaps in content of care involved iron and folic acid supplementation and malaria prevention. It is important that intermittent preventive treatment and insecticide-treated net use during pregnancy be increased in malaria endemic areas to protect the mother and fetus from the effects of malaria and to decrease the possible risk of adverse effects of iron if iron folic acid supplements or multiple micronutrient supplements are provided."
INFORMATION:
(doi:10.1001/jama.2015.10032; Available pre-embargo to the media at http:/media.jamanetwork.com)
Editor's Note: Both authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported.
The lack of adherence to usability testing standards among several widely used electronic health record (EHR) products that were certified as having met these requirements may be a major factor contributing to the poor usability of EHRs, according to a study in the September 8 issue of JAMA.
Many EHRs have poor usability, leading to user frustration and safety risks. The U.S. Department of Health and Human Services' Office of the National Coordinator for Health Information Technology (ONC) has established certification requirements to promote usability practices by EHR ...
Banning smoking in the workplace and increasing taxes on cigarettes have discouraged teens and young adults from taking up smoking, according to a study by researchers at UC San Francisco and UC Merced.
The study, published today (Sept. 8, 2015) in JAMA Pediatrics, used data on the smoking habits of a group of 12- to 18-year-olds living throughout the country in 1997. They were tracked for 11 years as they transitioned to young adults.
The researchers found that a 100 percent smoke-free environment reduced the odds of taking up smoking by one third and that the number ...
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The research was led by the London School of Hygiene & Tropical Medicine, in collaboration with the International Organization for Migration, and included interviews with 387 children and adolescents aged 10 to 17 years in post-trafficking services in Cambodia, Thailand and Vietnam.
Researchers found that one third of boys and girls surveyed had experienced ...
A study of extremely preterm infants born at U.S academic medical centers over the last 20 years found changes in maternal and infant care practices, resulting in modest increases in survival and reductions in several neonatal complications.
The study will be published in the September 8 issue of JAMA.
Overall survival increased most significantly in infants born at 23-24 weeks, but survival without major health problems identified prior to hospital discharge increased most in infants 25-28 weeks. The study found an increase in one complication of prematurity, however ...
ANN ARBOR--Solar cells capture up to 40 percent more energy when they can track the sun across the sky, but conventional, motorized trackers are too heavy and bulky for pitched rooftops and vehicle surfaces.
Now, by borrowing from kirigami, the ancient Japanese art of paper cutting, researchers at the University of Michigan have developed solar cells that can have it both ways.
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"It all depends on the type of test doctors use to diagnose patients," said Christopher R. Polage, associate ...
Forensic biomedical scientists from KU Leuven, Belgium, have developed a test to predict individuals' age on the basis of blood or teeth samples. This test may be particularly useful for the police, as it can help track down criminals or identify human remains.
When forensic examiners find traces of blood at a crime scene, they can try to identify the perpetrator on the basis of DNA. From now on, the blood samples can also be used to predict the criminal's age. This is also the case for deceased individuals: when traditional methods do not lead to identification, the ...
Researchers at Lund University in Sweden may have discovered one of the keys to understanding how the body develops acute pancreatitis. The results offer hope for the development of drugs that specifically target the disease.
Within gastro research it is a well-known fact that the excessive activation of a type of white blood cells, neutrophils, causes the inflammation of the pancreas. Until now, however, there has been no satisfactory explanation for what causes neutrophil activation. Three research groups at Lund University have worked together to find an answer.
"Our ...
Chicago, September 8, 2015 - A new statistical model may help predict which patients are most likely to receive life-extending benefits from surgical treatment for malignant pleural mesothelioma (MPM), according to an article in the September 2015 issue of the Annals of Thoracic Surgery.
Key points
A new statistical model may help identify which patients will benefit most from surgery for malignant pleural mesothelioma.
Younger age, no history of asbestos exposure, epithelioid histology, and a low number of affected lymph nodes were strongly associated with better ...
Researchers at the University of Bonn have discovered how cells in the body can detect the genetic material of so-called retroviruses. The pathogen of the immunodeficiency disease AIDS, the HI-1 virus, also belongs to this group. At the same time, the HI virus appears to circumvent this important defense mechanism. The researchers are now presenting their results in the renowned journal Nature Immunology.
The first line of defense of the immune system against pathogens is innate immunity. It is based on specialized sensor proteins, the receptors. These receptors detect ...
