Determinants of Urogenital Schistosomiasis Among Pregnant Women and its Association With Pregnancy Outcomes, Neonatal Deaths, and Child Growth

Wellington Murenjekwa, Rachel Makasi, Robert Ntozini, Bernard Chasekwa, Kuda Mutasa, Lawrence H. Moulton, James M. Tielsch, Jean H. Humphrey, Laura E. Smith, Andrew J. Prendergast, Claire D. Bourke

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: Schistosoma haematobium is a parasitic helminth that causes urogenital pathology. The impact of urogenital schistosomiasis during pregnancy on birth outcomes and child growth is poorly understood. METHODS: Risk factors for urogenital schistosomiasis were characterized among 4437 pregnant women enrolled in a cluster-randomized community-based trial in rural Zimbabwe. Infection was defined via urine microscopy (≥1 S. haematobium egg) and urinalysis (hematuria). Associations between infection and pregnancy outcomes were assessed in case-control analyses using conditional logistic regression. The association of maternal infection with birthweight and length-for-age Z scores (LAZ) at 1 and 18 months of age were assessed using generalized estimating equations. RESULTS: Urogenital schistosomiasis (egg positive and/or hematuria positive) was detected in 26.8% of pregnant women. Risk factors significantly associated with infection were maternal age, education, marital status, and religion; household drinking water source and latrine; study region; and season. Urogenital schistosomiasis was not significantly associated with adverse pregnancy outcomes (miscarriage, stillbirth, preterm, and small-for-gestational age), birthweight, neonatal death, or LAZ. CONCLUSIONS: Including pregnant women in antihelminthic treatment programs would benefit a large number of women in rural Zimbabwe. However, clearance of the low-intensity infections that predominate in this context is unlikely to have additive benefits for pregnancy outcomes or child growth. CLINICAL TRIALS REGISTRATION: NCT01824940.

Original languageEnglish (US)
Pages (from-to)1433-1444
Number of pages12
JournalThe Journal of infectious diseases
Volume223
Issue number8
DOIs
StatePublished - Apr 23 2021

Keywords

  • Schistosoma haematobium
  • Zimbabwe
  • adverse birth outcomes
  • birthweight
  • child health
  • pregnancy
  • schistosomiasis
  • stunting
  • women

ASJC Scopus subject areas

  • Immunology and Allergy
  • Infectious Diseases

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