Associations of maternal iron deficiency with malaria infection in a cohort of pregnant Papua New Guinean women
Abstract Background Iron deficiency (ID) is common in malaria-endemic settings. Intermittent preventative treatment of malaria in pregnancy (IPTp) and iron supplementation are core components of antenatal care in endemic regions to prevent adverse pregnancy outcomes. ID has been associated with redu...
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ftdoajarticles:oai:doaj.org/article:89c6e8486cfe4b56b0b1f8cc8091fe76 2023-05-15T15:16:20+02:00 Associations of maternal iron deficiency with malaria infection in a cohort of pregnant Papua New Guinean women Holger W. Unger Andie Bleicher Maria Ome-Kaius Elizabeth H. Aitken Stephen J. Rogerson 2022-05-01T00:00:00Z https://doi.org/10.1186/s12936-022-04177-8 https://doaj.org/article/89c6e8486cfe4b56b0b1f8cc8091fe76 EN eng BMC https://doi.org/10.1186/s12936-022-04177-8 https://doaj.org/toc/1475-2875 doi:10.1186/s12936-022-04177-8 1475-2875 https://doaj.org/article/89c6e8486cfe4b56b0b1f8cc8091fe76 Malaria Journal, Vol 21, Iss 1, Pp 1-11 (2022) Iron deficiency Iron supplementation Plasmodium falciparum Plasmodium vivax Risk Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2022 ftdoajarticles https://doi.org/10.1186/s12936-022-04177-8 2022-12-31T03:02:08Z Abstract Background Iron deficiency (ID) is common in malaria-endemic settings. Intermittent preventative treatment of malaria in pregnancy (IPTp) and iron supplementation are core components of antenatal care in endemic regions to prevent adverse pregnancy outcomes. ID has been associated with reduced risk of malaria infection, and correspondingly, iron supplementation with increased risk of malaria infection, in some studies. Methods A secondary analysis was conducted amongst 1888 pregnant women enrolled in a malaria prevention trial in Papua New Guinea. Maternal ID was defined as inflammation-corrected plasma ferritin levels < 15 μg/L at antenatal enrolment. Malaria burden (Plasmodium falciparum, Plasmodium vivax) was determined by light microscopy, polymerase chain reaction, and placental histology. Multiple logistic and linear regression analyses explored the relationship of ID or ferritin levels with indicators of malaria infection. Models were fitted with interaction terms to assess for modification of iron-malaria relationships by gravidity or treatment arm. Results Two-thirds (n = 1226) and 13.7% (n = 258) of women had ID and peripheral parasitaemia, respectively, at antenatal enrolment (median gestational age: 22 weeks), and 18.7% (120/1,356) had evidence of malaria infection on placental histology. Overall, ID was associated with reduced odds of peripheral parasitaemia at enrolment (adjusted odds ratio [aOR] 0.50; 95% confidence interval [95% CI] 0.38, 0.66, P < 0.001); peripheral parasitaemia at delivery (aOR 0.68, 95% CI 0.46, 1.00; P = 0.050); and past placental infection (aOR 0.35, 95% CI 0.24, 0.50; P < 0.001). Corresponding increases in the odds of infection were observed with two-fold increases in ferritin levels. There was effect modification of iron-malaria relationships by gravidity. At delivery, ID was associated with reduced odds of peripheral parasitaemia amongst primigravid (AOR 0.44, 95% CI 0.25, 0.76; P = 0.003), but not multigravid women (AOR 1.12, 95% CI 0.61, 2.05; P = ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Malaria Journal 21 1 |
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op_collection_id |
ftdoajarticles |
language |
English |
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Iron deficiency Iron supplementation Plasmodium falciparum Plasmodium vivax Risk Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
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Iron deficiency Iron supplementation Plasmodium falciparum Plasmodium vivax Risk Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 Holger W. Unger Andie Bleicher Maria Ome-Kaius Elizabeth H. Aitken Stephen J. Rogerson Associations of maternal iron deficiency with malaria infection in a cohort of pregnant Papua New Guinean women |
topic_facet |
Iron deficiency Iron supplementation Plasmodium falciparum Plasmodium vivax Risk Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
description |
Abstract Background Iron deficiency (ID) is common in malaria-endemic settings. Intermittent preventative treatment of malaria in pregnancy (IPTp) and iron supplementation are core components of antenatal care in endemic regions to prevent adverse pregnancy outcomes. ID has been associated with reduced risk of malaria infection, and correspondingly, iron supplementation with increased risk of malaria infection, in some studies. Methods A secondary analysis was conducted amongst 1888 pregnant women enrolled in a malaria prevention trial in Papua New Guinea. Maternal ID was defined as inflammation-corrected plasma ferritin levels < 15 μg/L at antenatal enrolment. Malaria burden (Plasmodium falciparum, Plasmodium vivax) was determined by light microscopy, polymerase chain reaction, and placental histology. Multiple logistic and linear regression analyses explored the relationship of ID or ferritin levels with indicators of malaria infection. Models were fitted with interaction terms to assess for modification of iron-malaria relationships by gravidity or treatment arm. Results Two-thirds (n = 1226) and 13.7% (n = 258) of women had ID and peripheral parasitaemia, respectively, at antenatal enrolment (median gestational age: 22 weeks), and 18.7% (120/1,356) had evidence of malaria infection on placental histology. Overall, ID was associated with reduced odds of peripheral parasitaemia at enrolment (adjusted odds ratio [aOR] 0.50; 95% confidence interval [95% CI] 0.38, 0.66, P < 0.001); peripheral parasitaemia at delivery (aOR 0.68, 95% CI 0.46, 1.00; P = 0.050); and past placental infection (aOR 0.35, 95% CI 0.24, 0.50; P < 0.001). Corresponding increases in the odds of infection were observed with two-fold increases in ferritin levels. There was effect modification of iron-malaria relationships by gravidity. At delivery, ID was associated with reduced odds of peripheral parasitaemia amongst primigravid (AOR 0.44, 95% CI 0.25, 0.76; P = 0.003), but not multigravid women (AOR 1.12, 95% CI 0.61, 2.05; P = ... |
format |
Article in Journal/Newspaper |
author |
Holger W. Unger Andie Bleicher Maria Ome-Kaius Elizabeth H. Aitken Stephen J. Rogerson |
author_facet |
Holger W. Unger Andie Bleicher Maria Ome-Kaius Elizabeth H. Aitken Stephen J. Rogerson |
author_sort |
Holger W. Unger |
title |
Associations of maternal iron deficiency with malaria infection in a cohort of pregnant Papua New Guinean women |
title_short |
Associations of maternal iron deficiency with malaria infection in a cohort of pregnant Papua New Guinean women |
title_full |
Associations of maternal iron deficiency with malaria infection in a cohort of pregnant Papua New Guinean women |
title_fullStr |
Associations of maternal iron deficiency with malaria infection in a cohort of pregnant Papua New Guinean women |
title_full_unstemmed |
Associations of maternal iron deficiency with malaria infection in a cohort of pregnant Papua New Guinean women |
title_sort |
associations of maternal iron deficiency with malaria infection in a cohort of pregnant papua new guinean women |
publisher |
BMC |
publishDate |
2022 |
url |
https://doi.org/10.1186/s12936-022-04177-8 https://doaj.org/article/89c6e8486cfe4b56b0b1f8cc8091fe76 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Malaria Journal, Vol 21, Iss 1, Pp 1-11 (2022) |
op_relation |
https://doi.org/10.1186/s12936-022-04177-8 https://doaj.org/toc/1475-2875 doi:10.1186/s12936-022-04177-8 1475-2875 https://doaj.org/article/89c6e8486cfe4b56b0b1f8cc8091fe76 |
op_doi |
https://doi.org/10.1186/s12936-022-04177-8 |
container_title |
Malaria Journal |
container_volume |
21 |
container_issue |
1 |
_version_ |
1766346625938096128 |