The association of parasitic infections in pregnancy and maternal and fetal anemia: a cohort study in coastal Kenya.

<h4>Background</h4>Relative contribution of these infections on anemia in pregnancy is not certain. While measures to protect pregnant women against malaria have been scaling up, interventions against helminthes have received much less attention. In this study, we determine the relative...

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Autores principales:	Elizabeth M McClure, Steven R Meshnick, Peter Mungai, Indu Malhotra, Christopher L King, Robert L Goldenberg, Michael G Hudgens, Anna Maria Siega-Riz, Arlene E Dent
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/9d414fac0fd64c989519fab46d2c66d3
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spelling	oai:doaj.org-article:9d414fac0fd64c989519fab46d2c66d32021-11-18T09:16:20ZThe association of parasitic infections in pregnancy and maternal and fetal anemia: a cohort study in coastal Kenya.1935-27271935-273510.1371/journal.pntd.0002724https://doaj.org/article/9d414fac0fd64c989519fab46d2c66d32014-02-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24587473/?tool=EBIhttps://doaj.org/toc/1935-2727https://doaj.org/toc/1935-2735<h4>Background</h4>Relative contribution of these infections on anemia in pregnancy is not certain. While measures to protect pregnant women against malaria have been scaling up, interventions against helminthes have received much less attention. In this study, we determine the relative impact of helminthes and malaria on maternal anemia.<h4>Methods</h4>A prospective observational study was conducted in coastal Kenya among a cohort of pregnant women who were recruited at their first antenatal care (ANC) visit and tested for malaria, hookworm, and other parasitic infections and anemia at enrollment. All women enrolled in the study received presumptive treatment with sulfadoxine-pyrimethamine, iron and multi-vitamins and women diagnosed with helminthic infections were treated with albendazole. Women delivering a live, term birth, were also tested for maternal anemia, fetal anemia and presence of infection at delivery.<h4>Principal findings</h4>Of the 706 women studied, at the first ANC visit, 27% had moderate/severe anemia and 71% of women were anemic overall. The infections with highest prevalence were hookworm (24%), urogenital schistosomiasis (17%), trichuria (10%), and malaria (9%). In adjusted and unadjusted analyses, moderate/severe anemia at first ANC visit was associated with the higher intensities of hookworm and P. falciparum microscopy-malaria infections. At delivery, 34% of women had moderate/severe anemia and 18% of infants' cord hemoglobin was consistent with fetal anemia. While none of the maternal infections were significantly associated with fetal anemia, moderate/severe maternal anemia was associated with fetal anemia.<h4>Conclusions</h4>More than one quarter of women receiving standard ANC with IPTp for malaria had moderate/severe anemia in pregnancy and high rates of parasitic infection. Thus, addressing the role of co-infections, such as hookworm, as well as under-nutrition, and their contribution to anemia is needed.Elizabeth M McClureSteven R MeshnickPeter MungaiIndu MalhotraChristopher L KingRobert L GoldenbergMichael G HudgensAnna Maria Siega-RizArlene E DentPublic Library of Science (PLoS)articleArctic medicine. Tropical medicineRC955-962Public aspects of medicineRA1-1270ENPLoS Neglected Tropical Diseases, Vol 8, Iss 2, p e2724 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270
spellingShingle	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Elizabeth M McClure Steven R Meshnick Peter Mungai Indu Malhotra Christopher L King Robert L Goldenberg Michael G Hudgens Anna Maria Siega-Riz Arlene E Dent The association of parasitic infections in pregnancy and maternal and fetal anemia: a cohort study in coastal Kenya.
description	<h4>Background</h4>Relative contribution of these infections on anemia in pregnancy is not certain. While measures to protect pregnant women against malaria have been scaling up, interventions against helminthes have received much less attention. In this study, we determine the relative impact of helminthes and malaria on maternal anemia.<h4>Methods</h4>A prospective observational study was conducted in coastal Kenya among a cohort of pregnant women who were recruited at their first antenatal care (ANC) visit and tested for malaria, hookworm, and other parasitic infections and anemia at enrollment. All women enrolled in the study received presumptive treatment with sulfadoxine-pyrimethamine, iron and multi-vitamins and women diagnosed with helminthic infections were treated with albendazole. Women delivering a live, term birth, were also tested for maternal anemia, fetal anemia and presence of infection at delivery.<h4>Principal findings</h4>Of the 706 women studied, at the first ANC visit, 27% had moderate/severe anemia and 71% of women were anemic overall. The infections with highest prevalence were hookworm (24%), urogenital schistosomiasis (17%), trichuria (10%), and malaria (9%). In adjusted and unadjusted analyses, moderate/severe anemia at first ANC visit was associated with the higher intensities of hookworm and P. falciparum microscopy-malaria infections. At delivery, 34% of women had moderate/severe anemia and 18% of infants' cord hemoglobin was consistent with fetal anemia. While none of the maternal infections were significantly associated with fetal anemia, moderate/severe maternal anemia was associated with fetal anemia.<h4>Conclusions</h4>More than one quarter of women receiving standard ANC with IPTp for malaria had moderate/severe anemia in pregnancy and high rates of parasitic infection. Thus, addressing the role of co-infections, such as hookworm, as well as under-nutrition, and their contribution to anemia is needed.
format	article
author	Elizabeth M McClure Steven R Meshnick Peter Mungai Indu Malhotra Christopher L King Robert L Goldenberg Michael G Hudgens Anna Maria Siega-Riz Arlene E Dent
author_facet	Elizabeth M McClure Steven R Meshnick Peter Mungai Indu Malhotra Christopher L King Robert L Goldenberg Michael G Hudgens Anna Maria Siega-Riz Arlene E Dent
author_sort	Elizabeth M McClure
title	The association of parasitic infections in pregnancy and maternal and fetal anemia: a cohort study in coastal Kenya.
title_short	The association of parasitic infections in pregnancy and maternal and fetal anemia: a cohort study in coastal Kenya.
title_full	The association of parasitic infections in pregnancy and maternal and fetal anemia: a cohort study in coastal Kenya.
title_fullStr	The association of parasitic infections in pregnancy and maternal and fetal anemia: a cohort study in coastal Kenya.
title_full_unstemmed	The association of parasitic infections in pregnancy and maternal and fetal anemia: a cohort study in coastal Kenya.
title_sort	association of parasitic infections in pregnancy and maternal and fetal anemia: a cohort study in coastal kenya.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/9d414fac0fd64c989519fab46d2c66d3
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The association of parasitic infections in pregnancy and maternal and fetal anemia: a cohort study in coastal Kenya.

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