Update of pre- and postnatal iron supplementation in malaria endemic settings

Semin Perinatol. 2019 Aug;43(5):291-296. doi: 10.1053/j.semperi.2019.03.019. Epub 2019 Mar 16.


This review focuses on pre- and post-natal iron supplementation in malaria endemic settings. Although iron supplementation can reduce iron deficiency, malaria infection may counteract this effect by the increase of hepcidin, and iron supplementation may further worsen malaria infection by providing additional iron for the parasites. However, most iron supplementation intervention studies in pregnant women with malaria have not shown a negative impact, although malaria treatment with iron supplementation may be beneficial in terms of improving birth outcomes. In infants and young children in malaria endemic settings, the adverse effects of iron supplementation has been well documented and malaria prevention and treatment with iron supplementation is recommended. Besides fostering the growth of malaria parasites, iron may also promote potential pathogens in the gut and cause an inflammatory response in young children. Overall, iron supplementation is beneficial for treating iron deficiency, but needs to be considered in the context of malaria prevention and treatment in pregnant women, infants and young children for safety and effectiveness.

Keywords: Infections; Iron deficiency; Malaria prevention; Microbiome; Pregnancy.

Publication types

  • Review

MeSH terms

  • Adult
  • Anemia, Iron-Deficiency / prevention & control*
  • Child, Preschool
  • Dietary Supplements / adverse effects
  • Endemic Diseases
  • Female
  • Guidelines as Topic
  • Hepcidins / blood
  • Humans
  • Infant
  • Infant, Newborn
  • Iron, Dietary / administration & dosage*
  • Iron, Dietary / adverse effects
  • Iron, Dietary / therapeutic use
  • Malaria / blood
  • Malaria / drug therapy*
  • Male
  • Maternal Health*
  • Maternal Nutritional Physiological Phenomena
  • Pregnancy
  • Pregnancy Complications, Infectious / blood
  • Pregnancy Complications, Infectious / drug therapy*
  • Pregnancy Complications, Parasitic / blood
  • Pregnancy Complications, Parasitic / drug therapy*


  • Hepcidins
  • Iron, Dietary