Determinants of Urogenital Schistosomiasis Among Pregnant Women and its Association With Pregnancy Outcomes, Neonatal Deaths, and Child Growth. (13th December 2019)

• Record Type: Journal Article
• Authors: Murenjekwa, Wellington; Makasi, Rachel; Ntozini, Robert; Chasekwa, Bernard; Mutasa, Kuda; Moulton, Lawrence H; Tielsch, James M; Humphrey, Jean H; Smith, Laura E; Prendergast, Andrew J; Bourke, Claire D
• Is Part Of: Journal of infectious diseases. Volume 223:Number 8(2021)
• Page Start: 1433
• Page End: 1444
• Publication Date: 2019-12-13
• Subjects: schistosomiasis -- pregnancy -- women -- Zimbabwe -- adverse birth outcomes -- birthweight -- stunting -- Schistosoma haematobium -- child health; Communicable diseases -- Periodicals; Diseases -- Causes and theories of causation -- Periodicals; Medicine -- Periodicals; Communicable Diseases -- Periodicals; Electronic journals; 616.9
• DOI: 10.1093/infdis/jiz664
• Languages: English
• ISSNs: 0022-1899

Abstract

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. Abstract : Urogenital schistosomiasis is common among pregnant women in rural Zimbabwe (n = 4437 in this study), but infection was not associated with adverse pregnancy outcomes, neonatal deaths, birthweight, or child length-for-age Z scores at 1 or 18 months of age.