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Nutritional deficiency and malaria are 2 major causes of anaemia during pregnancy in tropical areas. The relationship between anaemia, its treatment with iron and folate, and malaria was studied in a prospective cohort of 2112 pregnant Karen women on the north-western border of Thailand between 1993 and 1997. The development of Plasmodium vivax malaria was associated with a past mean haematocrit > 30% (hazard ratio = 1.5, 95% CI 1.2-2, P = 0.001) and recent (< or = 30 d) iron and folate supplementation (hazard ratio = 1.7, 95% CI 1.1-2.6, P = 0.01). There were no associations with P. falciparum infections. Plasmodium vivax has a predilection for young erythrocytes, and these results suggest that pregnant women with larger numbers of circulating young red cells are at greater risk of developing P. vivax malaria. In P. vivax-endemic areas, systematic iron and folate supplementation confers both benefit and risk in pregnancy.

Original publication

DOI

10.1016/s0035-9203(03)90140-4

Type

Journal article

Journal

Trans R Soc Trop Med Hyg

Publication Date

05/2003

Volume

97

Pages

273 - 276

Keywords

Adult, Anemia, Female, Follow-Up Studies, Hematinics, Hematocrit, Humans, Malaria, Falciparum, Malaria, Vivax, Pregnancy, Pregnancy Complications, Hematologic, Pregnancy Complications, Parasitic, Risk Factors, Thailand