Malawi Trial Raises Iron Levels in Pregnant Women

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Malawi Trial Raises Iron Levels in Pregnant Women

A study seeking new ways to combat anemia in developing countries found that a single iron injection, compared to daily pills, could significantly reduce iron deficiency in pregnant women.

The World Health Organization (WHO) currently recommends twice-daily oral iron supplements as standard treatment in developing countries, but adherence to this treatment is poor.

To find a more effective way to treat iron-deficient patients, WEHI researchers collaborated with Malawian scientists from the Training Research Unit of Excellence and Kamuzu University of Health Sciences to develop iron carboxymaltose (FCM). It was compared with standard of care oral iron. Half of the Malawian women (431) received her FCM in the second trimester and the other half received standard of care oral iron supplements.

Professor Sant-Rayn Pasricha, a leading anemia expert and head of WEHI’s Department of Population Health and Immunity, said the trial was four times larger than the one conducted to bring FCM to market. I was.

“When we first embarked on this trial, people thought we were trying to achieve the impossible,” said Professor Pasricha, also a hematologist.

“We have not only demonstrated that FCM can be safely administered in resource-limited and complex environments such as Malawi, but it can also reduce the iron deficiency component of anemia by approximately 60%. is far superior to the oral iron supplements currently recommended in these populations.

“The results show that women who received FCM throughout the study had significantly reduced iron deficiency and iron deficiency anemia in the third trimester of pregnancy, at delivery and at 4 weeks postpartum.

“This opens up a whole new area of ​​research previously thought impossible and could help transform health policies in vulnerable communities.

“I am very excited that a drug that is widely used in high-income countries could be applied to help women in sub-Saharan Africa and other resource-poor settings. Our next task is to identify women who are most likely to benefit from IV treatment.”

Pregnant women with anemia are at increased risk of complications such as postpartum hemorrhage, stillbirth, and low birth weight. Despite significant improvements in iron levels, this trial found that FCM was not superior to oral iron in reducing the overall burden of anemia in pregnant women We found that it did not reduce the incidence of low birth weight or anemia.

This is because anemia can be caused by factors other than iron deficiency in developing countries, researchers say. can promote inflammation in the body and impede access to stored iron,” said Professor Kamija Fili, principal epidemiologist and director of training and training. Research Unit of Excellence.

“In addition, hemoglobinopathies – a group of inherited blood disorders that primarily affect red blood cells – are common in the region and cause anemia.”

Professor Pasricha said the results underscore the urgent need for new mechanisms to address these unique health challenges. “More than half of the participants had inflammation in their bodies even though they tested negative for malaria,” he said.

“Because there are parasites that can hide in the placenta during pregnancy, current tests may not be sensitive enough to understand the full health of the mother and the risks to the fetus.

“In developed countries, blood tests can be done to detect determinants of anemia such as ferritin, but in these parts of the world there are no such tools to measure iron status.

“Our study demonstrates the urgent need for field-friendly testing capabilities for iron status and causes of anemia, providing important insights into where and how medicines such as FCM should be used. will provide.”

As FCM remains an expensive treatment option, the researchers hope the promising results will encourage further research into this intervention and philanthropic efforts to make it more accessible to women in low-income settings. is.

The research team is currently following the mothers and their babies who participated in this study to assess whether the intervention affects the prevalence of anemia, postpartum depression, and neurodevelopment in children.

Funded by the Bill & Melinda Gates Foundation and a National Health and Medical Research Council (NHMRC) Investigator Grant awarded to Professor Pasricha, the results of the study are: lancet.

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