Researchers at the University of Sydney have found the combined intake of iron-folic acid supplements with World Health Organisation (WHO)-endorsed anti-malarial drugs during pregnancy could reduce early infant mortality in sub-Saharan Africa by a quarter.
Worldwide, approximately 247 million cases of malaria each year result in almost a million deaths, mostly among African children. There has been some suggestion the use of antenatal iron-folic acid supplement - generally recommended during all pregnancies - increases malaria among women and children in sub-Saharan Africa.
Researchers at the Sydney School of Public Health, led by Dr Christiana Titaley, analysed data from 19 malaria-endemic African countries to investigate the effect of combining iron-folic acid supplements with malarial prophylaxis during pregnancy. Specifically, they looked at the relationship between the use of these medications and neonatal death (during the first 30 days of life).
"Only about one sixth of the 185,000-plus women investigated took a combination of folic/iron supplements and WHO-recommended sulfadoxine-pyramethamine anti-malarial drugs during pregnancy," Dr Titaley says. "These women's children were 24 percent less likely to die in the first month of life than infants whose mothers used neither.
"The prevalence of malaria in many parts of Africa muddies the advice given to most expecting mothers to take iron/folic acid supplements to reduce the risk of anaemia and birth defects," says Dr Titaley.
"Combining these with effective anti-malarial medication can significantly reduce neonatal mortality in at-risk regions of the world. This is especially true in regions with limited health care resources.
"We hope these findings will help clarify the message to expecting mothers in such areas."
The paper Combined iron/folic acid supplements and malaria prophylaxis reduce neonatal mortality in 19 sub-Saharan African countries has been published in the latest edition of the American Journal of Clinical Nutrition.
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