Gies Sabine, Roberts Stephen A, Diallo Salou, Lompo Olga M, Tinto Halidou, Brabin Bernard J
Department of Biomedical Sciences, Prince Leopold Institute of Tropical Medicine, Antwerp, Belgium.
Medical Mission Institute, Wurzburg, Germany.
Matern Child Nutr. 2021 Apr;17(2):e13106. doi: 10.1111/mcn.13106. Epub 2020 Nov 25.
This study in Burkina Faso investigated whether offspring of young mothers who had received weekly periconceptional iron supplementation in a randomised controlled trial were at increased risk of malaria. A child safety survey was undertaken in the peak month of malaria transmission towards the end of the trial to assess child iron biomarkers, nutritional status, anaemia and malaria outcomes. Antenatal iron biomarkers, preterm birth, fetal growth restriction and placental pathology for malaria and chorioamnionitis were assessed. Data were available for 180 babies surviving to the time of the survey when their median age was 9 months. Prevalence of maternal iron deficiency in the last trimester based on low body iron stores was 16%. Prevalence of active placental malaria infection was 24.8%, past infection 59% and chorioamnionitis 55.6%. Babies of iron supplemented women had lower median gestational age. Four out of five children ≥ 6 months were iron deficient, and 98% were anaemic. At 4 months malaria prevalence was 45%. Child iron biomarkers, anaemia and malaria outcomes did not differ by trial arm. Factors associated with childhood parasitaemia were third trimester C-reactive protein level (OR 2.1; 95% CI 1.1-3.9), active placental malaria (OR 5.8; 1.0-32.5, P = 0.042) and child body iron stores (OR 1.13; 1.04-1.23, P = 0.002). Chorioamnionitis was associated with reduced risk of child parasitaemia (OR 0.4; 0.1-1.0, P = 0.038). Periconceptional iron supplementation of young women did not alter body iron stores of their children. Higher child body iron stores and placental malaria increased risk of childhood parasitaemia.
这项在布基纳法索开展的研究调查了在一项随机对照试验中孕期每周接受补铁的年轻母亲的后代患疟疾风险是否增加。在试验接近尾声时的疟疾传播高峰期进行了一项儿童安全调查，以评估儿童的铁生物标志物、营养状况、贫血情况和疟疾感染结果。评估了产前铁生物标志物、早产、胎儿生长受限以及胎盘疟疾和绒毛膜羊膜炎的病理情况。调查时180名存活婴儿的数据可用，他们的中位年龄为9个月。基于低机体铁储备，孕晚期母亲缺铁的患病率为16%。活动性胎盘疟疾感染的患病率为24.8%，既往感染为59%，绒毛膜羊膜炎为55.6%。补铁女性的婴儿中位孕周较低。五分之四的6个月及以上儿童缺铁，98%贫血。4个月时疟疾患病率为45%。儿童铁生物标志物、贫血情况和疟疾感染结果在各试验组间无差异。与儿童寄生虫血症相关的因素有孕晚期C反应蛋白水平（比值比2.1；95%置信区间1.1 - 3.9）、活动性胎盘疟疾（比值比5.8；1.0 - 32.5，P = 0.042）和儿童机体铁储备（比值比1.13；1.04 - 1.23，P = 0.002）。绒毛膜羊膜炎与儿童寄生虫血症风险降低相关（比值比0.4；0.1 - 1.0，P = 0.038）。年轻女性孕期补铁未改变其子女的机体铁储备。较高的儿童机体铁储备和胎盘疟疾会增加儿童患寄生虫血症的风险。
