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Urogenital schistosomiasis during pregnancy is associated with low birth weight delivery: analysis of a prospective cohort of pregnant women and their offspring in Gabon.
Int J Parasitol. 2017 01; 47(1):69-74.IJ

Abstract

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.

Authors+Show Affiliations

Centre de Recherches Médicales de Lambaréné (CERMEL), Albert Schweitzer Hospital, BP 118 Lambaréné, Gabon; Institute of Tropical Medicine, University of Tübingen, 72074 Tübingen, Germany; German Centre for Infection Research (DZIF), Partner Site Tübingen, Germany; Département de Parasitologie-Mycologie, Université des Sciences de la Santé, BP 4009 Libreville, Gabon; Leiden University Medical Centre (LUMC), 2333 ZA Leiden, The Netherlands.Centre de Recherches Médicales de Lambaréné (CERMEL), Albert Schweitzer Hospital, BP 118 Lambaréné, Gabon; Institute of Tropical Medicine, University of Tübingen, 72074 Tübingen, Germany; German Centre for Infection Research (DZIF), Partner Site Tübingen, Germany.Centre de Recherches Médicales de Lambaréné (CERMEL), Albert Schweitzer Hospital, BP 118 Lambaréné, Gabon; Institute of Tropical Medicine, University of Tübingen, 72074 Tübingen, Germany; German Centre for Infection Research (DZIF), Partner Site Tübingen, Germany.Centre de Recherches Médicales de Lambaréné (CERMEL), Albert Schweitzer Hospital, BP 118 Lambaréné, Gabon; Institute of Tropical Medicine, University of Tübingen, 72074 Tübingen, Germany; German Centre for Infection Research (DZIF), Partner Site Tübingen, Germany.Centre de Recherches Médicales de Lambaréné (CERMEL), Albert Schweitzer Hospital, BP 118 Lambaréné, Gabon; Institute of Tropical Medicine, University of Tübingen, 72074 Tübingen, Germany; German Centre for Infection Research (DZIF), Partner Site Tübingen, Germany.Centre de Recherches Médicales de Lambaréné (CERMEL), Albert Schweitzer Hospital, BP 118 Lambaréné, Gabon; Institute of Tropical Medicine, University of Tübingen, 72074 Tübingen, Germany; German Centre for Infection Research (DZIF), Partner Site Tübingen, Germany.Centre de Recherches Médicales de Lambaréné (CERMEL), Albert Schweitzer Hospital, BP 118 Lambaréné, Gabon; Institute of Tropical Medicine, University of Tübingen, 72074 Tübingen, Germany; German Centre for Infection Research (DZIF), Partner Site Tübingen, Germany.Centre de Recherches Médicales de Lambaréné (CERMEL), Albert Schweitzer Hospital, BP 118 Lambaréné, Gabon; Institute of Tropical Medicine, University of Tübingen, 72074 Tübingen, Germany; German Centre for Infection Research (DZIF), Partner Site Tübingen, Germany.Ngounie Medical Research Centre, BP 133 Fougamou, Gabon.ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain.Centre de Recherches Médicales de Lambaréné (CERMEL), Albert Schweitzer Hospital, BP 118 Lambaréné, Gabon; Institute of Tropical Medicine, University of Tübingen, 72074 Tübingen, Germany; German Centre for Infection Research (DZIF), Partner Site Tübingen, Germany.Leiden University Medical Centre (LUMC), 2333 ZA Leiden, The Netherlands.ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain.Centre de Recherches Médicales de Lambaréné (CERMEL), Albert Schweitzer Hospital, BP 118 Lambaréné, Gabon; Institute of Tropical Medicine, University of Tübingen, 72074 Tübingen, Germany; German Centre for Infection Research (DZIF), Partner Site Tübingen, Germany.Centre de Recherches Médicales de Lambaréné (CERMEL), Albert Schweitzer Hospital, BP 118 Lambaréné, Gabon; Institute of Tropical Medicine, University of Tübingen, 72074 Tübingen, Germany; German Centre for Infection Research (DZIF), Partner Site Tübingen, Germany; Leiden University Medical Centre (LUMC), 2333 ZA Leiden, The Netherlands.Centre de Recherches Médicales de Lambaréné (CERMEL), Albert Schweitzer Hospital, BP 118 Lambaréné, Gabon; Institute of Tropical Medicine, University of Tübingen, 72074 Tübingen, Germany; Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Medical University of Vienna, 1090 Vienna, Austria. Electronic address: Michael.ramharter@meduniwien.ac.at.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

28003151

Citation

Mombo-Ngoma, Ghyslain, et al. "Urogenital Schistosomiasis During Pregnancy Is Associated With Low Birth Weight Delivery: Analysis of a Prospective Cohort of Pregnant Women and Their Offspring in Gabon." International Journal for Parasitology, vol. 47, no. 1, 2017, pp. 69-74.
Mombo-Ngoma G, Honkpehedji J, Basra A, et al. Urogenital schistosomiasis during pregnancy is associated with low birth weight delivery: analysis of a prospective cohort of pregnant women and their offspring in Gabon. Int J Parasitol. 2017;47(1):69-74.
Mombo-Ngoma, G., Honkpehedji, J., Basra, A., Mackanga, J. R., Zoleko, R. M., Zinsou, J., Agobe, J. C., Lell, B., Matsiegui, P. B., Gonzales, R., Agnandji, S. T., Yazdanbakhsh, M., Menendez, C., Kremsner, P. G., Adegnika, A. A., & Ramharter, M. (2017). Urogenital schistosomiasis during pregnancy is associated with low birth weight delivery: analysis of a prospective cohort of pregnant women and their offspring in Gabon. International Journal for Parasitology, 47(1), 69-74. https://doi.org/10.1016/j.ijpara.2016.11.001
Mombo-Ngoma G, et al. Urogenital Schistosomiasis During Pregnancy Is Associated With Low Birth Weight Delivery: Analysis of a Prospective Cohort of Pregnant Women and Their Offspring in Gabon. Int J Parasitol. 2017;47(1):69-74. PubMed PMID: 28003151.
* Article titles in AMA citation format should be in sentence-case
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, Y1 - 2016/12/18/ PY - 2016/08/20/received PY - 2016/11/03/revised PY - 2016/11/07/accepted PY - 2016/12/23/pubmed PY - 2017/8/2/medline PY - 2016/12/23/entrez KW - Gabon KW - Low birth-weight KW - Pregnancy KW - Prematurity KW - Schistosomiasis SP - 69 EP - 74 JF - International journal for parasitology JO - Int. J. Parasitol. VL - 47 IS - 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. SN - 1879-0135 UR - https://www.unboundmedicine.com/medline/citation/28003151/Urogenital_schistosomiasis_during_pregnancy_is_associated_with_low_birth_weight_delivery:_analysis_of_a_prospective_cohort_of_pregnant_women_and_their_offspring_in_Gabon_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0020-7519(16)30270-3 DB - PRIME DP - Unbound Medicine ER -