scholarly journals Maternal factors of newborn low birthweight in malaria endemic settings of Nanoro, rural Burkina Faso

2020 ◽  
Author(s):  
Moussa Lingani ◽  
Serge H. Zango ◽  
Innocent Valéa ◽  
Daniel Valia ◽  
Maïmouna Sanou ◽  
...  
Keyword(s):  
Burkina Faso ◽  
Birth Outcomes ◽  
Low Birthweight ◽  
Intermittent Preventive Treatment ◽  
Sub Saharan Africa ◽  
Bed Nets ◽  
P Value ◽  
Maternal Factors ◽  
Cross Sectional ◽  
Increased Risk

Abstract Background. In sub-Saharan Africa, the intermittent preventive treatment of malaria in pregnancy using sulphadoxine pyrimethamine (IPTp-SP) strategy is recommended to limit malaria adverse effects on birth outcomes. Ten year after IPTp-SP was adopted in Burkina Faso, we assessed the magnitude and maternal factors of low birthweight (LBW) in Nanoro.Methods. A secondary analysis of data from a cross-sectional study was carried out in women who gave birth at Nanoro peripheral health centers using a binary multivariate logistic regression. Maternal socio-demographic factors, gyneco-obstetrical history and relevant medical characteristics were evaluated to identify associated factors. A p-value less than 0.05 was considered statistically significant.Results. Of 291 delivery records examined, 14 % of women received three or more doses of SP while 80% used bed nets the night before their admission for delivery. Malaria was detected in 36.1% and anemia in 52.9% of women. The average neonate birthweight was 2933 g and 12 % were born with a low birthweight. By multivariate analysis, first delivery (OR = 8.84, [95% CI: 3.72-21.01]), and being multiparous with history of stillbirth (OR = 5.03, [95% CI: 1.54-16.40]) were significantly associated with an increased risk of LBW.Conclusion. LBW was still prevalent in rural Nanoro and the uptake of three or more doses of SP for the IPTp was low. In addition, to improving the coverage of the 3-dose IPTp-SP, it may be necessary to target interventions aiming to reduce maternal anemia such as adequate nutrients uptake to mitigate the issue of adverse birth outcomes.

scholarly journals Maternal Factors of Newborn Low Birthweight in Malaria Endemic Settings of Nanoro, Rural Burkina Faso

2020 ◽  
Author(s):  
Moussa Lingani ◽  
Henri S. Zango ◽  
Innocent Valéa ◽  
Daniel Valia ◽  
Maïmouna Sanou ◽  
...  
Keyword(s):  
Burkina Faso ◽  
Low Birthweight ◽  
Intermittent Preventive Treatment ◽  
Preventive Treatment ◽  
Sub Saharan Africa ◽  
Bed Nets ◽  
P Value ◽  
Maternal Factors ◽  
Cross Sectional ◽  
Increased Risk

Abstract Background. In sub-Saharan Africa, the intermittent preventive treatment of malaria in pregnancy with sulphadoxine pyrimethamine (IPTp-SP) strategy is recommended to limit malaria consequences on birth outcomes. Ten year after IPTp-SP was adopted in Burkina Faso, we assessed the magnitude of low birthweight (LBW) and its maternal factors in Nanoro.Methods. A secondary analysis of data from a cross-sectional study was carried out in women who gave birth at Nanoro peripheral health centers using a binary multivariate logistic regression. Maternal socio-demographic factors, gyneco-obstetrical history and relevant medical characteristics were evaluated to identify associated factors. A p-value less than 0.05 was considered statistically significant.Results. Of 291 delivery records examined, 14 % of women received three or more doses of SP while 80% used bed nets the night before their admission for delivery. Malaria was detected in 36.1% and anemia in 52.9% of women. The average neonate birthweight was 2933 g and 12 % of them were born with a low birthweight. After multivariate analysis, first delivery (OR = 8.84, [95% CI: 3.72-21.01]), and being multiparous with history of stillbirth (OR = 5.03, [95% CI: 1.54-16.40]) were significantly associated with an increased risk of LBW.Conclusion. LBW is still prevalent in rural Nanoro and the uptake of three or more doses of SP for the IPTp was low. In addition, to improving the coverage of IPTp-SP to improve birthweight, an extension of the target of antenatal care to other known causes of LBW including curable sexually transmitted infections may be necessary.

scholarly journals Adolescent, Pregnant, and HIV-Infected: Risk of Adverse Pregnancy and Perinatal Outcomes in Young Women from Southern Mozambique

2021 ◽  
Vol 10 (8) ◽  
pp. 1564
Author(s):  
Clara Pons-Duran ◽  
Aina Casellas ◽  
Azucena Bardají ◽  
Anifa Valá ◽  
Esperança Sevene ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Maternal Morbidity ◽  
Low Birthweight ◽  
Negative Binomial ◽  
Perinatal Outcomes ◽  
Sub Saharan Africa ◽  
P Value ◽  
Increased Risk ◽  
Adverse Pregnancy ◽  
The Impact

Sub-Saharan Africa concentrates the burden of HIV and the highest adolescent fertility rates. However, there is limited information about the impact of the interaction between adolescence and HIV infection on maternal health in the region. Data collected prospectively from three clinical trials conducted between 2003 and 2014 were analysed to evaluate the association between age, HIV infection, and their interaction, with the risk of maternal morbidity and adverse pregnancy and perinatal outcomes in women from southern Mozambique. Logistic regression and negative binomial models were used. A total of 2352 women were included in the analyses; 31% were adolescents (≤19 years) and 29% HIV-infected women. The effect of age on maternal morbidity and pregnancy and perinatal adverse outcomes was not modified by HIV status. Adolescence was associated with an increased incidence of hospital admissions (IRR 0.55, 95%CI 0.37–0.80 for women 20–24 years; IRR 0.60, 95%CI 0.42–0.85 for women >25 years compared to adolescents; p-value < 0.01) and outpatient visits (IRR 0.86, 95%CI 0.71–1.04; IRR 0.76, 95%CI 0.63–0.92; p-value = 0.02), and an increased likelihood of having a small-for-gestational age newborn (OR 0.50, 95%CI 0.38–0.65; OR 0.43, 95%CI 0.34–0.56; p-value < 0.001), a low birthweight (OR 0.40, 95%CI 0.27–0.59; OR 0.37, 95%CI 0.26–0.53; p-value <0.001) and a premature birth (OR 0.42, 95%CI 0.24–0.72; OR 0.51, 95%CI 0.32–0.82; p-value < 0.01). Adolescence was associated with an increased risk of poor morbidity, pregnancy and perinatal outcomes, irrespective of HIV infection. In addition to provision of a specific maternity care package for this vulnerable group interventions are imperative to prevent adolescent pregnancy.

scholarly journals Malaria Preventive Practices among Pregnant Women in Akwa Ibom State, Southern Nigeria

2020 ◽  
pp. 1-8
Author(s):  
T. Kasso ◽  
I. L. Oboro ◽  
O. Maduka ◽  
A. T. O. Awopeju ◽  
N. I. Paul ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Intermittent Preventive Treatment ◽  
Open Data ◽  
Public Health Problem ◽  
Preventive Treatment ◽  
Health Facilities ◽  
Bed Nets ◽  
P Value ◽  
Cross Sectional ◽  
Preventive Practices

Background: Malaria is a serious public health problem in developing countries with Africa bearing most of its burden. Pregnant women are more susceptible to malaria and it is one of the leading causes of maternal and perinatal mortality/morbidity. Use of effective malaria preventive measures during pregnancy reduces its burden and complications. Aim: This was to determine malaria preventive practices used by pregnant women in Akwa Ibom state, Nigeria. Materials and Methods: It was a cross sectional study of pregnant women attending public and private health facilities in Akwa Ibom state. An informed written consent was obtained from the participants. Stratified sampling method was used in selecting the health facilities and the study participants. Information was obtained with pretested questionnaires by trained personnel with the aid of Open Data Kit (ODK) on android phones. Data was managed with SPSS 22.0 and P-value of <0.05 was considered statistically significant. Results: There were 935 participants in the study. Their mean age was 28.52 ± 5.09 years with 879 (94.0%) being married. Most had secondary and tertiary degrees: 451(48.2%) and 440(47.1%). Majority of them were traders/business women and self-employed (58.2%) while 7% were unemployed. Malaria preventive practices were use of window net, bed net and insecticides accounting for 659(71%), 447(48.2%) and 207(22.3%) respectively. There were 612 (65.5%) participants that received malaria drugs for prevention with 452(73.9%) receiving Intermittent Preventive Treatment in Pregnancy (IPTp) with Sulfadoxine-Pyrimethamine (SP). Only 296 (31.7%) of them slept under bed nets the night before the interview. Conclusion: Common preventive practices employed by pregnant women were IPTp with SP, window nets, ITNs and modified IRS. Majority of the women utilized widow nets, though not as effective as ITNs. Efforts should be intensified concerning awareness creation about the benefits of ITN use during pregnancy.

scholarly journals Personal Oral Infection Control, Low Birthweight, and Preterm Births in Appalachia West Virginia: A Cross-Sectional Study

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
R. Constance Wiener ◽  
Christopher Waters
Keyword(s):  
Oral Health ◽  
West Virginia ◽  
Infection Control ◽  
Birth Outcomes ◽  
Odds Ratio ◽  
Low Birthweight ◽  
Preterm Births ◽  
Oral Infection ◽  
Cross Sectional ◽  
Powered Toothbrush

Introduction. Appalachia West Virginia has a higher prevalence of preterm and low birthweight babies than the US national prevalence. Many factors have been studied which are known to influence preterm births and low birthweight babies. There are limited interventions that are available to decrease the likelihood of preterm and low birthweight babies; however oral health and personal oral infection control may be helpful. The purpose of this study was to evaluate the association of limited personal oral infection control among pregnant West Virginia Appalachian women and poor birth outcomes (preterm and low birthweight babies). Methods. A secondary data analysis of data from the West Virginia Healthy Start Helping Appalachian Parents and Infants (HAPI) Project from 2005 to 2016 was conducted. The researchers determined the odds ratio of personal oral infection control with a powered toothbrush (use of the brush fewer than 13 times per week versus use of the brush 13 or more times per week) on poor birth outcomes. Results. There were 845 women who completed the oral health program within the HAPI project. In unadjusted logistic regression, women who used the powered toothbrush and brushed less frequently had greater odds of poor birth outcomes than women who brushed more frequently (odds ratio of 2.07 [1.18, 3.62] P = 0.011 for low birthweight babies; and an odds ratio of 1.78 [1.04, 3.02] P = 0.034 for preterm birth). The results remained positive but were no longer significant in adjusted analysis. Conclusion. There is a need to identify interventions that will benefit pregnant women so that their pregnancies result in healthy pregnancy outcomes.

scholarly journals Maternal and Neonatal Outcomes Associated with Psychostimulant Use in Pregnancy

2020 ◽  
Vol 5 (5) ◽  
Author(s):  
Ximena Camacho ◽  
Alys Havard ◽  
Helga Zoega ◽  
Margaret Wilson ◽  
Tara Gomes ◽  
...  
Keyword(s):  
Birth Outcomes ◽  
Neonatal Intensive Care ◽  
Low Birthweight ◽  
Cohort Analysis ◽  
Neonatal Outcomes ◽  
Increased Risk ◽  
The Usa ◽  
Maternal And Neonatal Outcomes ◽  
Adverse Pregnancy ◽  
In Pregnancy

IntroductionRecent evidence from the USA and Nordic countries suggests a possible association between psychostimulant use during gestation and adverse pregnancy and birth outcomes. Objectives and ApproachWe employed a distributed cohort analysis using linked administrative data for women who gave birth in New South Wales (NSW; Australia) and Ontario (Canada), whereby a common protocol was implemented separately in each jurisdiction. The study population comprised women who were hospitalized for a singleton delivery over an 8 (NSW) and 4 (Ontario) year period, respectively, with the NSW cohort restricted to social security beneficiaries. Psychostimulant exposure was defined as at least one dispensing of methylphenidate, amphetamine, dextroamphetamine or lisdexamfetamine during pregnancy. We examined the risk of maternal and neonatal outcomes among psychostimulant exposed mothers compared with unexposed mothers. ResultsThere were 140,356 eligible deliveries in NSW and 449,499 in Ontario during the respective study periods. Fewer than 1% of these pregnancies were exposed to psychostimulants during gestation, although use was higher in Ontario (0.30% vs 0.11% in NSW). Preliminary unadjusted analyses indicated possible associations between psychostimulant use in pregnancy and higher risks of pre-term birth (relative risk [RR] 1.7, 95% confidence interval [CI] 1.4-2.0 (Ontario); RR 1.8, 95% CI 1.2-2.6 (NSW)) and pre-eclampsia (RR 2.0, 95% CI 1.5-2.6 (Ontario); RR 2.0, 95% CI 1.2-3.5 (NSW)). Similarly, psychostimulant use was associated with higher risks of low birthweight (RR 1.6, 95% CI 1.3-1.9 (Ontario); RR 2.0, 95% CI 1.3-3.0 (NSW)) and admission to neonatal intensive care (RR 2.1, 95% CI 1.9-2.3 (Ontario); RR 1.5, 95% CI 1.1-1.9 (NSW)). Conclusion / ImplicationsUnadjusted analyses indicate an increased risk of adverse maternal and birth outcomes associated with psychostimulant exposure during pregnancy, potentially representing a placental effect. We are currently refining the analyses, employing propensity score methods to adjust for confounding.

scholarly journals COMPUTER VISION SYNDROME: PREVALENCE AND ASSOCIATED RISK FACTORS AMONG UNDERGRADUATES IN A TERTIARY INSTITUTION IN NORTH WESTERN NIGERIA

2021 ◽  
Vol 15 (1) ◽  
pp. 1-8
Author(s):  
Nwankwo B ◽  
◽  
Mumueh KP ◽  
Olorukooba AA ◽  
Usman NO
Keyword(s):  
Risk Factors ◽  
Computer Vision ◽  
Computer Use ◽  
P Value ◽  
Tertiary Institution ◽  
Blurred Vision ◽  
Cross Sectional ◽  
Computer Vision Syndrome ◽  
Increased Risk ◽  
Associated Risk Factors

Background: Computers and other visual display devices have become essential in the present era and have led to a rise in computer-related health problems. Using computers in homes, universities and other institutions has increased output greatly but has also led to an increased risk of developing Computer vision syndrome (CVS). Objectives: To determine the prevalence and risk factors associated with computer vision syndrome among undergraduates. Methodology: A cross-sectional study was conducted among153 respondents who were selected using a multi-stage sampling technique. A pretested, structured, interviewer-administered questionnaire was used to collect data. SPSS version 23 was used to analyze the data. A Chi-square test was used to determine the relationship between CVS and associated risk factors at a P-value of <0.05. Results: The mean age of respondents was 22.4 ± 3.4 years. The prevalence of CVS in this study was 83 (54.3%). The common symptoms experienced among the respondents were headache (51, 61.4%), eye strain (48, 57.8%) and blurred vision (42, 50.6%). The risk factors significantly associated with CVS in this study were duration of computer use, hours of computer use per day, level of a computer screen and taking breaks during computer use. Conclusion: About half of the students in this study had at least one symptom of CVS. Therefore, awareness of CVS should be created by the institution during which students would be educated on CVS and its prevention.

scholarly journals The Latent Tuberculin Test after 1-year Therapy with Anti-TNF in Babylon, Iraq

2018 ◽  
Vol 26 (8) ◽  
pp. 144-150
Author(s):  
Ali Alkazzaz ◽  
Murtadha Najah Jawad ◽  
Zeyad Tareq Kareem
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Medical History ◽  
Demographic Data ◽  
Latent Tuberculosis ◽  
Tuberculin Test ◽  
P Value ◽  
Cross Sectional ◽  
Increased Risk ◽  
Significant Difference

Background: Rheumatoid arthritis (RA) patients receiving receive anti-TNF agents are at increased risk of reactivation of latent tuberculosis infection (LTBI). The tuberculin skin test (TST) is widely used to screen LTBI and providing preventive treatment, in an effort to meet the WHO target of a 90% reduction in TB by 2035. Objectives: To determine the proportion of TST conversion among RA patients after 1 year of anti-TNF treatment and association of positive TST result with patients’ socio-demographic characteristics and medical history. Methods: This community-based cross-sectional study was conducted at the Department of Rheumatology of Marjan Teaching Hospital in Iraq, for a period of 1 year. Patients with RA/and spondyloarthropathy, and who received anti-TNF therapy for >1 year, underwent TST. Their demographic data and medical history were also obtained. All statistical analysis was performed using SPSS (Version 20) and, p < 0.05 was considered as a sign. Data from the baseline and 1 year follow-up was subjected to the Kolmogorov-Smirnov test to determine whether they were normally distributed. Chi-Square test used to test significance of TST among etanrecept and infliximab at the end of the study. Results: A total of 96 patients were enrolled, including 55 (57.3%) males and 41 (42.3%) females with an average age of 41.1, and mostly 68 (70.8%) from Babylon Governorate of Iraq. A total of 40 (41.7%) patients had rheumatoid arthritis alone, and the remaining 56 (58.3%) had a comorbidity of spondyloarthropathy. Majority of the patients 65 (67.7%) received the biological agent infliximab, while 31 (32.3%) patients received Etanercept for RA for a period of 1 year. There was a statistically significant decreasing in the median ESR and disease activity  from the baseline to the end of the study (p-value <0.01). There was no significant difference in TST results based on gender or age. Both infliximab and etanercept were significantly associated with a decreasing  in ESR and disease activity Conclusion: This study has shown that there was very low TST conversion among RA patients after 1 year of anti-TNF treatment and, age and gender were not associated with TST.

scholarly journals Hubungan usia dan hipertensi terhadap kejadian BPH di RSUD. Dr. H. Abdul Moeloek tahun 2020

2021 ◽  
Vol 1 (3) ◽  
pp. 247-251
Author(s):  
Elsa Rizki Lilian ◽  
Andi Siswandi ◽  
Anggunan Anggunan
Keyword(s):  
Significant Relationship ◽  
Bivariate Analysis ◽  
P Value ◽  
Chi Square ◽  
Cross Sectional ◽  
Prostate Hyperplasia ◽  
Increased Risk ◽  
Surgical Ward ◽  
The Relationship ◽  
Lower Urinary

ABSTRACT: THE CORRELATIONS OF AGE AND HYPERTENSION WITH THE OCCURRENCE OF BPH IN THE SURGICAL WARD AT RSUD DR.H.ABDUL MOELOEK IN 2020Introduction: Lower Urinary Tractus Symptoms (LUTS) is a problem that is experienced by men around the world and one that often occurs is Benign prostate hyperplasia (BPH). BPH is a histological disorder characterized by the proliferation of prostate cells. It is estimated that 50% of men show BPH histopathology at the age of 60 years old and an increase of 90% at the age of 80 years old. Hypertension is also known to have a role in increasing prostate volume, in a cohort study it was found that hypertension resulted in an increased risk of 1.5 times to cause LUTS/BPH.Objective: To determine the relationship between age and hypertension on the incidence of BPH in Dr. H. Abdul Moeloek in 2020.Methods: This study is quantitative research, an observative analytic study design with a cross-sectional approach was carried out at RSUD Dr. H. Abdul Moeloek which was taken on October 16, 2020. The population was all patients in the Surgical Ward with total sampling. Data collection was obtained from secondary data from medical records. Data analysis was performed Univariate analysis (frequency distribution) and bivariate analysis with chi-square.Results: Respondents with BPH aged >50 years old were 32 respondents (97%) and respondents with BPH and hypertension were 20 respondents (60.6%). The results of the bivariate analysis using chi-square showed a significant relationship between BPH and age p value=0.000 (P<0.05) and the relationship between BPH and hypertension with p value=0.000 (p<0.05).Conclusion: There is a significant relationship between BPH with age and hypertension with the occurrence of BPH in the Surgical polyclinic at RSUD Dr.H.Abdul Moeloek in 2020. Keywords: BPH, Age, Hypertension  INTISARI: HUBUNGAN USIA DAN HIPERTENSI TERHADAP KEJADIAN BPH DI RSUD Dr.H.ABDUL MOELOEK Pendahuluan: Lower Urinary Tractus Symptoms (LUTS) adalah masalah yang banyak dialami oleh laki-laki di seluruh dunia dan salah satu yang sering terjadi adalah Benigna Prostat Hyperplasia (BPH). BPH adalah kelainan histologis yang khas di tandai dengan proliferasi sel-sel prostat. Diperkirakan 50% laki-laki menunjukan histopatologi BPH pada umur 60 tahun dan meningkat 90% pada umur 80 tahun  Hipertensi juga diketahui memiliki peranan dalam peningkatan volume prostat yakni pada suatu penelitian cohort diketahui adanya hipertensi mengakibatkan peningkatan resiko sebanyak 1,5 kali untuk menimbulkan gejala LUTS/BPH.Tujuan: Untuk mengetahui adanya hubungan usia dan hipertensi terhadap kejadian BPH di RSUD Dr. H. Abdul Moeloek Tahun 2020Metode: Jenis penelitian kuantitatif, rancangan penelitian analitik observatif dengan pendekatan cross sectional telah dilakukan di RSUD Dr.H.Abdul Moeloek Provinsi Lampung yang berlangsung pada 16 Oktober 2020. Populasi adalah seluruh pasien di Poli Bedah dengan pengambilan sampel secara total sampling. Pengumpulan data diperoleh dari data sekunder yang diperoleh dari rekam medis. Analisis data secara univariat (distribusi frekuensi) dan uji bivariat mengunakan chi squareHasil: Responden dengan BPH yang berusia >50 tahun sebanyak 32 responden (97%) dan responden dengan BPH dengan hipertensi sebanyak 20 responden (60,6%). Hasil Uji bivariat menggunakan chi square menunjukkan adanya hubungan signifikan antara BPH dengan usia diperoleh nilai p=0,000 (P<0,05) dan hubungan BPH dengan hipertensi nilai p=0,000 (p<0,05).Kesimpulan: Terdapat hubungan signifikan antara BPH dengan usia dan terdapat hubungan sgnifikan antara BPH dengan hipertensi di poli klinik bedah RSUD Dr.H.Abdul Moeloek tahun 2020.Kata kunci: BPH, Usia, Hipertensi

scholarly journals Pregnant Inuit Women’s Exposure to Metals and Association with Fetal Growth Outcomes: ACCEPT 2010–2015

2019 ◽  
Vol 16 (7) ◽  
pp. 1171 ◽  
Author(s):  
◽  
Eva Bonefeld-Jørgensen ◽  
Keyword(s):  
Heavy Metals ◽  
Birth Outcomes ◽  
Environmental Contaminants ◽  
Population Characteristics ◽  
The Arctic ◽  
Essential Metals ◽  
Toxic Heavy Metals ◽  
Cross Sectional ◽  
Normal Ranges ◽  
Increased Risk

Environmental contaminants such as heavy metals are transported to the Arctic regions via atmospheric and ocean currents and enter the Arctic food web. Exposure is an important risk factor for health and can lead to increased risk of a variety of diseases. This study investigated the association between pregnant women’s levels of heavy and essential metals and the birth outcomes of the newborn child. This cross-sectional study is part of the ACCEPT birth cohort (Adaption to Climate Change, Environmental Pollution, and dietary Transition) and included 509 pregnant Inuit women ≥18 years of age. Data were collected in five Greenlandic regions during 2010–2015. Population characteristics and birth outcomes were obtained from medical records and midwives, respectively, and blood samples were analyzed for 13 metals. Statistical analysis included one-way ANOVA, Spearman’s rho, and multiple linear and logistic regression analyses. The proportion of current smokers was 35.8%. The levels of cadmium, chromium, and nickel were higher compared to reported normal ranges. Significant regional differences were observed for several metals, smoking, and parity. Cadmium and copper were significantly inversely related to birth outcomes. Heavy metals in maternal blood can adversely influence fetal development and growth in a dose–response relationship. Diet and lifestyle factors are important sources of toxic heavy metals and deviant levels of essential metals. The high frequency of smokers in early pregnancy is of concern, and prenatal exposure to heavy metals and other environmental contaminants in the Greenlandic Inuit needs further research.

scholarly journals Does Iron Increase the Risk of Malaria in Pregnancy?

2015 ◽  
Vol 2 (2) ◽  
Author(s):  
Violeta Moya-Alvarez ◽  
Gilles Cottrell ◽  
Smaila Ouédraogo ◽  
Manfred Accrombessi ◽  
Achille Massougbodgi ◽  
...  
Keyword(s):  
Blood Smear ◽  
Intermittent Preventive Treatment ◽  
Malaria Risk ◽  
Sub Saharan Africa ◽  
Health Concern ◽  
Socioeconomic Indicators ◽  
Iron Deficient ◽  
Increased Risk ◽  
In Pregnancy

Abstract Background.  Pregnancy-associated malaria (PAM) remains a significant health concern in sub-Saharan Africa. Cross-sectional studies report that iron might be associated with increased malaria morbidity, raising fears that current iron supplementation policies will cause harm in the present context of increasing resistance against intermittent preventive treatment in pregnancy (IPTp). Therefore, it is necessary to assess the relation of iron levels with malaria risk during the entire pregnancy. Methods.  To investigate the association of maternal iron levels on malaria risk in the context of an IPTp clinical trial, 1005 human immunodeficiency virus-negative, pregnant Beninese women were monitored throughout their pregnancy between January 2010 and May 2011. Multilevel models with random intercept at the individual levels and random slope for gestational age were used to analyze the factors associated with increased risk of a positive blood smear and increased Plasmodium falciparum density. Results.  During the follow-up, 29% of the women had at least 1 episode of malaria. On average, women had 0.52 positive smears (95% confidence interval [CI], 0.44–0.60). High iron levels (measured by the log10 of ferritin corrected on inflammation) were significantly associated with increased risk of a positive blood smear (adjusted odds ratio = 1.75; 95% CI, 1.46–2.11; P &lt; .001) and high P falciparum density (beta estimate = 0.22; 95% CI, 0.18–0.27; P &lt; .001) during the follow-up period adjusted on pregnancy parameters, comorbidities, environmental and socioeconomic indicators, and IPTp regime. Furthermore, iron-deficient women were significantly less likely to have a positive blood smear and high P falciparum density (P &lt; .001 in both cases). Conclusions.  Iron levels were positively associated with increased PAM during pregnancy in the context of IPTp. Supplementary interventional studies are needed to determine the benefits and risks of differently dosed iron and folate supplements in malaria-endemic regions.

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