Prenatal Iron and Malaria Study
Prenatal Iron and Malaria Study
The purpose of this study is to compare the presence of Plasmodium infection in parturient
 women who antenatally received a combination of iron-fortified foods with iron supplements
 versus iron-fortified foods only.
As per recommendations by the World Health Organization (WHO), iron supplementation in
 children should be restricted in malaria-endemic areas because of concerns that it can lead
 to an increased burden of malaria. Universal iron supplementation continues to be
 recommended, however, for women during pregnancy and 3 months postpartum. Observational
 studies have shown that iron deficiency in parturient women is associated with a marked
 reduction in the prevalence and density of malarial parasites in the placenta. Plasmodium
 infections in pregnant women have devastating effects on the foetus and neonate, causing low
 birth weight, intrauterine growth retardation, preterm delivery, spontaneous abortion,
 stillbirth and neonatal mortality. Based on our previous work, the Kenyan government is
 currently drafting legislation for mandatory iron fortification of industrially milled flour.
 Implementation of the new fortification policy means that pregnant women will receive iron
 through a combination of fortified foods and supplementation. The investigators are concerned
 about the safety of the high iron intake resulting from such a policy.
Inclusion Criteria:

 -  Women aged 15-45 years resident in the predefined study area

 -  Pregnant, with gestational age <23 weeks

 Exclusion Criteria:

 -  Failure to provide a blood sample

 -  Initial haemoglobin concentration <90 g/L

 -  Reported medical history suggestive of sickle cell anaemia, epilepsy, diabetes

 -  Obstetric history suggestive of eclampsia or pre-eclampsia

 -  Obvious mental retardation or metabolic disorder;

 -  No written consent

 -  Carrying multiples

 -  Woman planning to leave the homestead or to be absent for prolonged periods in the
 course of the pregnancy or within a 1-month period thereafter

 -  Woman planning to deliver outside the research clinic.