Anaemia is an important risk factor for maternal death and low birth weight children. In the recent report card on maternal and child health, UNICEF cites figures that estimate that aneamia is the cause of death in 4-13% of all maternal deaths in Asia and Africa. It probably also contributes as a risk factor in another important fraction of deaths, for example as a complicating factor with malaria.

Simon Brooker, Peter Hotez, and Donald Bundy recently released a systematic review of the relationship between hookworm disease and anaemia in pregnant women. The relationship between hookworm disease and anaemia has in fact already been well established, especially among children. The authors confirm that this relationship appears to be common among pregnant and women of child bearing age, suggesting that they would also benefit from deworming.

Despite the fact that deworming drugs have been shown to be cheap, easy to integrate into existing health service delivery, and safe, even among pregnant women, deworming is rarely included into antenatal care in most areas where hookworm infections are common. There was no mention of it in the UNICEF report. Iron supplementation has already been recommended for pregnant women, but the combining with deworming drugs is likely to be even more effective. Clearly more research is needed to better understand the safety of such programs, but integration of deworming into existing antenatal care packages might represent a good low hanging fruit in improving maternal outcomes.

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