1. Determinants of Urogenital Schistosomiasis Among Pregnant Women and its Association With Pregnancy Outcomes, Neonatal Deaths, and Child Growth.
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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, and SHINE Trial Team
- Subjects
PREGNANCY outcomes ,PREGNANT women ,NEONATAL death ,GROWTH of children ,SCHISTOSOMIASIS ,RESEARCH ,TREMATODA ,CHILD development ,ANIMAL experimentation ,MICROSCOPY ,RESEARCH methodology ,EVALUATION research ,PERINATAL death ,COMPARATIVE studies ,BIRTH weight ,RESEARCH funding ,HEMATURIA ,URINALYSIS ,PARASITIC diseases in pregnancy ,DISEASE complications - 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 FROM AUTHOR]- Published
- 2021
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