Gyorkos Theresa W, Larocque Renee, Casapia Martin, Gotuzzo Eduardo
Division of Clinical Epidemiology, Department of Medicine, McGill University Health Centre, Montréal, Canada.
Pediatr Infect Dis J. 2006 Sep;25(9):791-4. doi: 10.1097/01.inf.0000234068.25760.97.
Pregnant women who live in hookworm-endemic areas may benefit from deworming during their pregnancy. The benefit derives from reducing anemia, primarily iron-deficiency anemia caused by hookworm infection-attributable blood loss. Where the prevalence of hookworm is more than 20% to 30%, the World Health Organization recommends that pregnant women receive anthelminthic treatment (mebendazole, albendazole, levamisole or pyrantel) after their first trimester. The objective of this study is to report, describe and compare the occurrence of adverse birth outcomes in a large randomized, controlled trial of antenatal mebendazole (500 mg single dose) plus iron supplements versus placebo plus iron supplements conducted between April 2003 and June 2004 in the Amazon region of Peru.
Physician-recorded data on adverse birth outcomes occurring during the trial (N = 1042) were obtained. Proportions were compared using chi analysis.
No statistically significant difference (P = 0.664) was found between the mebendazole group and the placebo group in terms of numbers of miscarriages, malformations, stillbirths, early neonatal deaths and premature babies (28 versus 31, respectively).
The evidence provided by this large randomized, controlled trial of mebendazole administered during pregnancy indicates that deworming with mebendazole can be safely included in antenatal care programs in hookworm-endemic areas.
生活在钩虫流行地区的孕妇在孕期进行驱虫可能有益。这种益处源于减少贫血,主要是由钩虫感染导致的失血引起的缺铁性贫血。当钩虫感染率超过20%至30%时,世界卫生组织建议孕妇在孕中期之后接受驱虫治疗(甲苯达唑、阿苯达唑、左旋咪唑或噻嘧啶)。本研究的目的是报告、描述和比较2003年4月至2004年6月在秘鲁亚马逊地区进行的一项大型随机对照试验中,产前使用甲苯达唑(单次剂量500毫克)加铁补充剂与安慰剂加铁补充剂的不良分娩结局的发生率。
获取了医生记录的试验期间发生的不良分娩结局数据(N = 1042)。使用卡方分析比较比例。
在流产、畸形、死产、早期新生儿死亡和早产婴儿数量方面,甲苯达唑组和安慰剂组之间未发现统计学上的显著差异(P = 0.664)(分别为28例和31例)。
这项关于孕期使用甲苯达唑的大型随机对照试验提供的证据表明,在钩虫流行地区,甲苯达唑驱虫可安全纳入产前保健项目。