![]() ![]() HIV/AIDS care was provided according to WHO guidelines antiretroviral therapy (ART) was not available to most women in Tanzania at the time of the study, including participants in this trial. Women received bottles of ninety tablets of Fe–folate supplements and were followed up at monthly visits. The detailed design of the trial has been described previously ( 15).Īll women received 120 mg of ferrous Fe (as ferrous sulfate) and 5 mg of folate daily during pregnancy starting at their first antenatal clinic visit, and chloroquine (300 mg) weekly as malaria prophylaxis, as per the then current standard of care in Tanzania. That study was conducted to examine the effects of daily micronutrient supplementation to HIV-infected pregnant women on the risks of mother-to-child HIV transmission, HIV disease progression and adverse perinatal outcomes. Participants were pregnant women between 12 and 27 weeks of gestation who were enrolled in the Trial of Vitamins (TOV), a double-blind, placebo-controlled randomized trial conducted in Dar es Salaam, Tanzania (1995–1997). We conducted a prospective observational analysis of incident anaemia and Fe deficiency during pregnancy and the postpartum period in HIV-infected women who were pregnant at enrolment and followed throughout the postpartum period. Risk factors for incident haematological outcomes need to be examined, to elucidate the aetiology of anaemia in HIV-infected pregnant women receiving Fe supplementation. Studies in HIV-infected pregnant women have found an extremely high prevalence of anaemia, despite presumed availability of Fe supplementation ( 2– 5) however, most have focused on cross-sectional assessments of anaemia prevalence during pregnancy. Nutritional deficiencies of folate and vitamin B 12 ( 14) and concurrent infections may also contribute to the risk of anaemia. In addition to Fe deficiency, anaemia of inflammation is a leading cause of anaemia in HIV-infected individuals ( 13). The aetiology of anaemia in the context of HIV is particularly complex. Fe supplementation (with folic acid) is standard prenatal care in most countries, based on its likely benefits in preventing maternal anaemia and related complications ( 12). A substantial body of evidence also supports the relationships between Fe deficiency and poorer cognitive development in children ( 10) and reduced work capacity in adults ( 11). ![]() The consequences of anaemia and Fe deficiency in pregnancy have been well established ( 7), and include maternal and infant mortality ( 8) and low birth weight ( 9). Several studies in Sub-Saharan Africa have identified a prevalence of 80% or higher in HIV-infected pregnant women ( 2– 5).įe deficiency is the leading cause of anaemia worldwide and in pregnancy ( 6). Approximately 50% of pregnant women have anaemia (Hb <110 g/l) in resource-limited settings, compared with 12–25% in developed regions ( 1). An estimated 1♶ billion people are anaemic worldwide, and anaemia is common during pregnancy ( 1). ![]()
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