Anemia Pregnancy Clinical Trial
Official title:
Causes and Impact of Anemia on Pregnancy Outcome on the Thai-Myanmar Border: Retrospective Analysis
The global burden of maternal morbidity and mortality attributable to anemia is staggering,
and this is especially true in low-resource settings. A recent review suggests 42% of
pregnant women have anemia worldwide (1993-2005) with the vast majority of anemic women (90%)
residing in Africa or Asia1; and in Asia, anemia was the second highest cause of maternal
mortality2. Anemia was diagnosed in almost one third to one half of women presenting to the
Shoklo Malaria Research Unit (SMRU) clinics on the Thai-Myanmar border for antenatal care
(ANC) in a 2008 survey3, and anemia at first antenatal visit was associated with a two-fold
increase in maternal mortality in this population4. Studies have also shown an association
between anemia and small for gestational age infants, preterm delivery, infant and childhood
anemia and developmental delays5.
The anemia in pregnant women presenting to SMRU clinics is multifactorial, as
hemoglobinopathies, Glucose-6-dehydrogenase (G6PD) deficiency, iron, folic acid and B12
deficiency, helminth infection, and malaria are all prevalent in this rural population.
Though all of these pathologies can cause anemia, they require different and sometimes
conflicting treatment and prevention strategies, interacting in a complex web of causes and
effects. Iron supplementation is the mainstay of most anemia control programs, but some women
with hemoglobinopathies suffer from potentially fatal iron overload6. Iron supplementation
has also been associated with increased risk of malaria7. Some helminth infections are
associated with increased rates of anemia and malaria, but others may be protective8. Malaria
and G6PD deficiency have complex effects on one another, and some malaria treatments can
cause acute and life-threatening hemolysis in G6PD deficient individuals9.
Given the high prevalence and diverse causes of anemia in this population, and its
potentially dire effects on maternal and infant health and survival, SMRU implemented
increased clinical testing for pregnant women in 2012 to inform clinical care at the
individual level. Further analysis of these data is urgently needed to improve care on a
population scale. We propose to review existing data from ANC records to determine the causes
and effects of anemia in this population, and use this information to improve treatment and
prevention guidelines. Results would be integrated rapidly into local practice with the
potential to have profound impacts on maternal and child health in this region.
n/a
| Status | Clinical Trial | Phase | |
|---|---|---|---|
| Completed |
NCT05644964 -
The Effect of Anemia in Adolescent and Advanced Age Pregnancies
|