MRC/UVRI Uganda Research Unit on AIDS, Uganda Virus Research Institute, PO Box 49, Entebbe, Uganda.
Parasitology. 2011 Oct;138(12):1499-507. doi: 10.1017/S0031182011001053. Epub 2011 Aug 3.
In 1994 and 2002, respectively, the World Health Organisation proposed that treatment for hookworm and schistosomiasis could be provided during pregnancy. It was hoped that this might have benefits for maternal anaemia, fetal growth and perinatal mortality; a beneficial effect on the infant response to immunisation was also hypothesised. Three trials have now been conducted. Two have examined the effects of benzimidazoles; one (the Entebbe Mother and Baby Study) the effects of albendazole and praziquantel. All three were conducted in settings of high prevalence but low intensity helminth infection. Results suggest that, in such settings and given adequate provision of haematinics, the benefit of routine anthelminthics during pregnancy for maternal anaemia may be small; none of the other expected benefits has yet been demonstrated. The Entebbe Mother and Baby Study found a significant adverse effect of albendazole on the incidence of infantile eczema in the whole study population, and of praziquantel on the incidence of eczema among infants of mothers with Schistosoma mansoni. Further studies are required in settings that differ in helminth species and infection intensities. Further research is required to determine whether increased rates of infantile eczema translate to long-term susceptibility to allergy, and to explore the underlying mechanisms of these effects. The risks and benefits of routine anthelminthic treatment in antenatal clinics may need to be reconsidered.
1994 年和 2002 年，世界卫生组织分别提出，钩虫病和血吸虫病的治疗可以在怀孕期间进行。人们希望这可能对母亲贫血、胎儿生长和围产期死亡率有好处；也假设对婴儿免疫反应有有益的影响。现在已经进行了三项试验。其中两项研究了苯并咪唑类药物的效果；其中一项（恩特贝母婴研究）研究了阿苯达唑和吡喹酮的效果。所有这三项试验都是在高流行率但低强度蠕虫感染的环境中进行的。结果表明，在这种环境下，并给予足够的血液补充剂，怀孕期间常规驱虫对母亲贫血的益处可能很小；其他预期的益处尚未得到证实。恩特贝母婴研究发现，阿苯达唑对整个研究人群中婴儿湿疹的发病率有显著的不良影响，吡喹酮对曼氏血吸虫感染母亲的婴儿湿疹发病率有显著的不良影响。在不同的蠕虫种类和感染强度的环境中，还需要进一步的研究。需要进一步的研究来确定婴儿湿疹发病率的增加是否会导致对过敏的长期易感性，并探讨这些影响的潜在机制。在产前诊所进行常规驱虫治疗的风险和益处可能需要重新考虑。
