Iron deficiency in pregnancy impacts half of women in low-income countries, as well as 12% in Australia and the UK. Pregnant women can develop iron deficiency anemia due to the added iron requirements of the foetus and higher volumes of blood in a women’s body during pregnancy.
It can lead to impaired fetal growth, a low birth weight and newborn deaths. The University of Sydney team also said it can predispose children to problems later in life such as low intelligence, obesity and behavioral problems.
Lactoferrin: Cheap and accessible option
"Lactoferrin could prove to be a cheap and accessible way to rapidly reverse some of the ill effects of iron deficiency that affect two billion people globally," said trail leader Michael Dibley, a professor at the University of Sydney.
Lactoferrin is a natural protein found in breast and cow's milk and a component of the human immune system with antiviral, anti-fungal, anti-bacterial, anti-carcinogenic and anti-inflammatory properties.
Trial in Bangladesh
The trial will administer lactoferrin in oral capsules to non-pregnant women in Bangladesh with iron deficiency anemia.
The researchers will initially compare lactoferrin with ferrous sulphate, which are iron sulphate tablets that are commonly used to address iron deficiencies.
"Iron sulphate is currently the standard first line of defense against anemia but it is suboptimal and has a host of negative side effects. For example, it is poorly absorbed, causes inflammatory problems, and poses a risk of accidental overdose and death in children if not safely stored,” said William Tarnow-Mordi professor of Neonatology at the University of Sydney.
Phase two & three
If lactoferrin proves a safer option, the trial will then add vitamin A and riboflavin to the milk protein capsules and compare the effects to ferrous sulphate. A third stage will compare lactoferrin with iron sulphate on birth outcomes.
"If the trial is effective, we will be working with our partners in Bangladesh and other regions in Asia and in Australia, New Zealand and Europe to raise the availability of lactoferrin," said Professor Dibley.
"To do this sustainably in Asian countries will mean scaling up the milk production capacity of those countries. This offers enormous benefits in terms of research and development, skills infrastructure capacity building, and employment."
The trial is backed by an international consortium including the Bill and Melinda Gates Foundation, USAID, the Norwegian Government, Grand Challenges Canada, and UK AID.