Division of Clinical Epidemiology, Department of Epidemiology, Biostatistics and Occupational Health, Research Institute of the McGill University Health Centre, McGill University, Montréal, QC, Canada.
Trop Med Int Health. 2011 Apr;16(4):531-7. doi: 10.1111/j.1365-3156.2011.02727.x. Epub 2011 Feb 1.
To assess the following associations between the second and third trimesters of pregnancy: (i) the intensity of soil-transmitted helminth (STH) infection and haemoglobin/anaemia, (ii) the effect of mebendazole treatment on the occurrence of STH infection, and (iii) the effect of mebendazole treatment on haemoglobin/anaemia.
Data originated from a trial of 1042 pregnant women recruited in their second trimester and followed to delivery. Baseline assessments included socio-demographic/health information from questionnaires, haemoglobin/anaemia from HemoCue ascertainment of fingerprick blood, and the presence and intensity of STH (Ascaris lumbricoides, hookworms and Trichuris trichiura) infections from Kato-Katz examination. All women were given iron supplements; half were randomly allocated to receive single dose 500 mg mebendazole, and half, placebo. Haemoglobin/anaemia and STH infection status were determined again in the third trimester of pregnancy.
Complete information was available from 935 (89.7%) women. Mebendazole significantly reduced the prevalence and intensity of all three STH infections. Higher intensities of hookworm and Trichuris infections in the second trimester were associated with a higher risk of anaemia in the third trimester. Overall, women with moderate/heavy Trichuris infection were found to be at a higher risk of anaemia; the highest risk was observed among those with moderate/heavy hookworm co-infection (adjusted OR = 2.77; 95% CI: 1.26, 6.11). Mebendazole treatment did not reduce the risk of anaemia.
Higher intensities of both Trichuris and hookworm infections are associated with anaemia in pregnancy. The importance of Trichuris infections during pregnancy requires renewed attention.
评估妊娠第二和第三 trimester 之间的以下关联：（i）土壤传播性蠕虫（STH）感染的强度和血红蛋白/贫血，（ii）甲苯咪唑治疗对 STH 感染发生的影响，以及（iii）甲苯咪唑治疗对血红蛋白/贫血的影响。
数据来自一项 1042 名孕妇的试验，这些孕妇在妊娠中期招募并随访至分娩。基线评估包括来自问卷的社会人口学/健康信息、手指血的 HemoCue 血红蛋白/贫血测定以及 Kato-Katz 检查的 STH（蛔虫、钩虫和鞭虫）感染的存在和强度。所有妇女均给予铁补充剂；一半随机分配接受单次 500mg 甲苯咪唑，另一半接受安慰剂。在妊娠第三 trimester 再次确定血红蛋白/贫血和 STH 感染状况。
935 名（89.7%）妇女提供了完整信息。甲苯咪唑显著降低了所有三种 STH 感染的患病率和强度。妊娠中期钩虫和鞭虫感染强度较高与妊娠晚期贫血风险较高相关。总体而言，中度/重度鞭虫感染的妇女发现贫血风险较高；中度/重度钩虫合并感染的妇女风险最高（调整后的 OR = 2.77；95%CI：1.26，6.11）。甲苯咪唑治疗并未降低贫血风险。
两种鞭虫和钩虫感染的强度较高与妊娠贫血相关。妊娠期间鞭虫感染的重要性需要重新引起关注。
