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Malawi trial boosts ironlevels in pregnant women

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A study exploring new ways to fight anaemia in developing nations has found a single iron infusion can significantly reduce iron deficiency in pregnant women compared with daily tablets.

The World Health Organisation (WHO) currently recommends oral iron taken twice daily as the standard of care in developing nations, but adherence to this treatment is poor.

Ferric carboxymaltose (FCM) is a 15-minute iron infusion treatment widely given to iron-deficient pregnant mothers in developed countries.

In efforts to find more effective ways of treating iron-deficient patients, Australian researchers from Walter and Eliza Hall Institute of Medical Research (Wehi) worked with Malawian scientists at the Training Research Unit of Excellence and Kamuzu University of Health Sciences to compare FCM to standard-of-care oral iron.

Half of the Malawian women, about 431, in their second trimester received FCM while the other half took standard-of-care oral iron.

Professor Sant-Rayn Pasricha, a leading anaemia expert and division head in Wehi’s Population Health and Immunity Division, said the trial was four times larger than the one conducted to bring FCM onto the market.

“When we first set out to do this trial, people thought we were trying to achieve the impossible,” Professor Pasricha, also a haematologist, said in a statement released yesterday by Wehi, a WHO-designated Centre for Anaemia Detection and Control

“We proved that FCM cannot only be safely administered in a complex resource-limited setting like Malawi, but can also reduce the iron deficiency component of anaemia by around 60 percent, a significantly better result than the oral iron currently recommended in these populations.

He said the results show women who received FCM throughout the trial had a substantial reduction in iron deficiency and iron deficiency anaemia during their third trimester, at delivery and 4-weeks postpartum.

The research team is currently tracking the mothers involved in this study and their babies to assess whether the intervention will impact on anaemia prevalence, post-partum depression and child neurodevelopment.

The study, “Ferric Carboxymal tose ver sus standard-of-care oral iron to treat second-trimester anaemia in Malawian pregnant women: a randomised controlled trial,” was published in The Lancet on April 19 2023.

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