Urogenital schistosomiasis during pregnancy is associated with low birth weight delivery: analysis of a prospective cohort of pregnant women and their offspring in Gabon

TY - JOUR

T1 - Urogenital schistosomiasis during pregnancy is associated with low birth weight delivery: analysis of a prospective cohort of pregnant women and their offspring in Gabon

AU - Mombo-Ngoma, Ghyslain

AU - Honkpehedji, Josiane

AU - Basra, Arti

AU - Mackanga, Jean Rodolphe

AU - Zoleko, Rella Manego

AU - Zinsou, Jeannot

AU - Agobe, Jean Claude Dejon

AU - Lell, Bertrand

AU - Matsiegui, Pierre-Blaise

AU - Gonzales, Raquel

AU - Agnandji, Selidji Todagbe

AU - Yazdanbakhsh, Maria

AU - Menendez, Clara

AU - Kremsner, Peter G

AU - Adegnika, Ayola Akim

AU - Ramharter, Michael

N1 - Copyright © 2016 Australian Society for Parasitology. Published by Elsevier Ltd. All rights reserved.

PY - 2017/1

Y1 - 2017/1

N2 - An estimated 40 million women of childbearing age suffer from schistosomiasis. Animal models indicate a deleterious effect of maternal schistosomiasis on pregnancy outcomes. To date there is a lack of epidemiological evidence evaluating schistosomiasis-related morbidity in pregnancy. This study was designed to describe the impact of urogenital schistosomiasis on pregnancy outcomes in a highly endemic region of central Africa. Pregnant women attending antenatal clinics in Fougamou and Lambaréné, Gabon, were consecutively screened for the presence of Schistosoma haematobium eggs in diurnal urine samples. Maternal and newborn characteristics assessed at delivery were compared between infected and uninfected mothers. The impact of maternal schistosomiasis on low birth weight and preterm delivery was assessed using logistic regression analysis. Urogenital schistosomiasis was diagnosed in 103 (9%) of 1115 pregnant women. Maternal age was inversely associated with the prevalence of urogenital schistosomiasis, with a higher burden amongst nulliparous women. Low birth weight was more common amongst infants of S. haematobium-infected mothers. This association was unaffected by controlling for demographic characteristics, gestational age and Plasmodium infection status (adjusted Odds Ratio 1.93; 95% confidence interval: 1.08-3.42). Other risk factors associated with low birth weight delivery were underweight mothers (adjusted Odds Ratio 2.34; 95% confidence interval: 1.12-4.92), peripheral or placental Plasmodium falciparum infection (adjusted Odds Ratio 2.04; 95% confidence interval: 1.18-3.53) and preterm birth (adjusted Odds Ratio 3.12; 95% confidence interval: 1.97-4.96). Preterm delivery was not associated with S. haematobium infection (adjusted Odds Ratio 1.07 95% confidence interval: 0.57-1.98). In conclusion, this study indicates that pregnant women with urogenital schistosomiasis are at an increased risk for low birth weight deliveries. Further studies evaluating targeted treatment and prevention programmes for urogenital schistosomiasis in pregnant women and their impact on delivery outcomes are warranted.

AB - An estimated 40 million women of childbearing age suffer from schistosomiasis. Animal models indicate a deleterious effect of maternal schistosomiasis on pregnancy outcomes. To date there is a lack of epidemiological evidence evaluating schistosomiasis-related morbidity in pregnancy. This study was designed to describe the impact of urogenital schistosomiasis on pregnancy outcomes in a highly endemic region of central Africa. Pregnant women attending antenatal clinics in Fougamou and Lambaréné, Gabon, were consecutively screened for the presence of Schistosoma haematobium eggs in diurnal urine samples. Maternal and newborn characteristics assessed at delivery were compared between infected and uninfected mothers. The impact of maternal schistosomiasis on low birth weight and preterm delivery was assessed using logistic regression analysis. Urogenital schistosomiasis was diagnosed in 103 (9%) of 1115 pregnant women. Maternal age was inversely associated with the prevalence of urogenital schistosomiasis, with a higher burden amongst nulliparous women. Low birth weight was more common amongst infants of S. haematobium-infected mothers. This association was unaffected by controlling for demographic characteristics, gestational age and Plasmodium infection status (adjusted Odds Ratio 1.93; 95% confidence interval: 1.08-3.42). Other risk factors associated with low birth weight delivery were underweight mothers (adjusted Odds Ratio 2.34; 95% confidence interval: 1.12-4.92), peripheral or placental Plasmodium falciparum infection (adjusted Odds Ratio 2.04; 95% confidence interval: 1.18-3.53) and preterm birth (adjusted Odds Ratio 3.12; 95% confidence interval: 1.97-4.96). Preterm delivery was not associated with S. haematobium infection (adjusted Odds Ratio 1.07 95% confidence interval: 0.57-1.98). In conclusion, this study indicates that pregnant women with urogenital schistosomiasis are at an increased risk for low birth weight deliveries. Further studies evaluating targeted treatment and prevention programmes for urogenital schistosomiasis in pregnant women and their impact on delivery outcomes are warranted.

KW - Adolescent

KW - Adult

KW - Animals

KW - Endemic Diseases

KW - Female

KW - Gabon/epidemiology

KW - Gestational Age

KW - Humans

KW - Infant

KW - Infant, Low Birth Weight

KW - Infant, Newborn

KW - Malaria/complications

KW - Malaria, Falciparum/complications

KW - Male

KW - Obstetric Labor, Premature/epidemiology

KW - Pregnancy

KW - Pregnancy Complications, Infectious/epidemiology

KW - Pregnancy Outcome/epidemiology

KW - Prevalence

KW - Prospective Studies

KW - Risk Factors

KW - Schistosoma haematobium/isolation & purification

KW - Schistosomiasis haematobia/diagnosis

KW - Young Adult

U2 - 10.1016/j.ijpara.2016.11.001

DO - 10.1016/j.ijpara.2016.11.001

M3 - SCORING: Journal article

C2 - 28003151

VL - 47

SP - 69

EP - 74

JO - INT J PARASITOL

JF - INT J PARASITOL

SN - 0020-7519

IS - 1

ER -