TY - JOUR
T1 - Determinants of Urogenital Schistosomiasis Among Pregnant Women and its Association With Pregnancy Outcomes, Neonatal Deaths, and Child Growth
AU - Murenjekwa, Wellington
AU - Makasi, Rachel
AU - Ntozini, Robert
AU - Chasekwa, Bernard
AU - Mutasa, Kuda
AU - Moulton, Lawrence H.
AU - Tielsch, James M.
AU - Humphrey, Jean H.
AU - Smith, Laura E.
AU - Prendergast, Andrew J.
AU - Bourke, Claire D.
N1 - Publisher Copyright:
© 2019 The Author(s). Published by Oxford University Press for the Infectious Diseases Society of America.
PY - 2021/4/15
Y1 - 2021/4/15
N2 - 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.
AB - 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.
KW - Schistosoma haematobium
KW - Zimbabwe
KW - adverse birth outcomes
KW - birthweight
KW - child health
KW - pregnancy
KW - schistosomiasis
KW - stunting
KW - women
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U2 - 10.1093/infdis/jiz664
DO - 10.1093/infdis/jiz664
M3 - Article
C2 - 31832636
AN - SCOPUS:85097510390
SN - 0022-1899
VL - 223
SP - 1433
EP - 1444
JO - Journal of Infectious Diseases
JF - Journal of Infectious Diseases
IS - 8
ER -