缺铁孕妇对恶性疟原虫感染的易感性降低。

Decreased susceptibility to Plasmodium falciparum infection in pregnant women with iron deficiency.

作者信息

Kabyemela Edward R, Fried Michal, Kurtis Jonathan D, Mutabingwa Theonest K, Duffy Patrick E

机构信息

Mother-Offspring Malaria Studies Project, Seattle Biomedical Research Institute, Seattle, Washington 98109, USA.

出版信息

J Infect Dis. 2008 Jul 15;198(2):163-6. doi: 10.1086/589512.

DOI:10.1086/589512

PMID:18500927

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.

摘要

在非洲疟疾流行地区，补充铁剂加叶酸会增加儿童的死亡率和发病率，但补充剂对疟疾流行地区孕妇的影响仍不明确。在坦桑尼亚东北部，疟疾和缺铁情况较为常见，我们发现，缺铁女性的胎盘疟疾患病率较低（8.5%对47.3%的女性；P<0.0001）且病情较轻（疟原虫密度中位数，胎盘红细胞的4.2%对6.3%；P<0.04），尤其是在首次怀孕时，缺铁女性比铁储备充足的女性情况更好。多变量分析显示，缺铁（P<0.0001）和多胎妊娠（P<0.002）显著降低了胎盘疟疾的风险。迫切需要在非洲疟疾流行地区进行孕期补充铁剂和叶酸的干预试验，以确定这种干预措施的益处和风险。