title: Decreased susceptibility to Plasmodium falciparum infection in pregnant women with iron deficiency.
abstract: 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; P< .0001) and less severe (median parasite density, 4.2% vs. 6.3% of placental red blood cells; P< .04) among women with iron deficiency than among women with sufficient iron stores, especially during the first pregnancy. Multivariate analysis revealed that iron deficiency (P< .0001) and multigravidity (P< .002) 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.
authors.affiliation: Mother-Offspring Malaria Studies Project, Seattle Biomedical Research Institute, Seattle, Washington 98109, USA.
authors.forename: Edward R
authors.initials: ER
authors.lastname: Kabyemela
authors.forename: Michal
authors.initials: M
authors.lastname: Fried
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Kurtis
authors.forename: Theonest K
authors.initials: TK
authors.lastname: Mutabingwa
authors.forename: Patrick E
authors.initials: PE
authors.lastname: Duffy
mesh_terms: D000818:Animals; D005260:Female; D006801:Humans; D007113:Immunity, Innate; D000090463:Iron Deficiencies; D016778:Malaria, Falciparum / Q000276:immunology* / Q000517:prevention & control*; D010920:Placenta / Q000469:parasitology / Q000473:pathology; D010963:Plasmodium falciparum / Q000472:pathogenicity*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000276:immunology* / Q000517:prevention & control*