Department of Parasitology, Faculty of Medical Sciences, Tarbiat Modares University, P.O. Box 14115-111, Tehran, Iran.
Department of Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Trans R Soc Trop Med Hyg. 2021 May 8;115(5):457-470. doi: 10.1093/trstmh/traa101.
Intestinal parasitic infections (IPIs) during pregnancy, if left untreated, can cause adverse effects for the mothers, foetuses and newborns. However, limited information is available about the global status of IPIs in pregnant women. Here we undertook a meta-analysis to estimate the global prevalence of IPIs and associated risk factors in pregnant women.
We searched the PubMed, Science Direct, Scopus, Web of Science and Google Scholar databases for relevant studies that were published between 1 January 1987 and 30 December 2019. A random effects meta-analysis model was used to estimate the pooled prevalence, odds ratios (ORs) and 95% confidence intervals (CIs).
A total of 114 studies comprising 98 342 pregnant women across 35 countries were included in the systematic review and meta-analysis. Among IPIs identified from pregnant women, three helminth infections (hookworm 19% [95% CI 15 to 23], Ascaris lumbricoides 17% [95% CI 13 to 21] and Trichuris trichiura 11% [95% CI 7 to 16]) and three protozoan infections (Blastocystis sp. 21% [95% CI 4 to 46], Entamoeba histolytica/dispar 9% [95% CI 3 to 19] and Giardia sp. 8% [95% CI 4 to 13]) were identified as the most prevalent intestinal parasites. Moreover, we found that there was a significant association between IPIs with increased risk of anaemia in pregnant women (OR 2.65 [95% CI 2.08 to 3.37]). The prevalence of IPIs was slightly higher in geophagic pregnant women compared with controls, but this was not significant (OR 1.22 [95% CI 0.87 to 1.71]). According to species, the pooled OR of A. lumbricoides infection had a significantly higher risk in geophagic pregnant women compared with controls (OR 2.66 [95% CI 1.37 to 5.16]). There was a positive relationship between the high prevalence of IPIs in pregnant women living in rural areas compared with urban residents (OR 3.36 [95% CI 1.57 to 7.19]).
The current review revealed a relatively high prevalence of IPIs in pregnant women, especially in some low- and middle-income countries. These results suggest a need for improved prevention and control efforts to reduce the health risks to pregnant women.
如果不加以治疗，孕妇体内的肠道寄生虫感染（IPI）会对母亲、胎儿和新生儿造成不良影响。然而，目前有关孕妇肠道寄生虫感染全球流行情况的信息有限。本研究通过荟萃分析，旨在估计全球孕妇肠道寄生虫感染的流行率及其相关危险因素。
我们检索了 1987 年 1 月 1 日至 2019 年 12 月 30 日期间发表的相关研究，包括 PubMed、Science Direct、Scopus、Web of Science 和 Google Scholar 数据库。采用随机效应荟萃分析模型来估计汇总患病率、比值比（OR）和 95%置信区间（CI）。
本系统评价和荟萃分析共纳入了来自 35 个国家的 114 项研究，共涉及 98342 名孕妇。在所确定的孕妇肠道寄生虫感染中，三种蠕虫感染（钩虫 19%[95%CI 15%至 23%]、蛔虫 17%[95%CI 13%至 21%]和鞭虫 11%[95%CI 7%至 16%]）和三种原虫感染（蓝氏贾第鞭毛虫 21%[95%CI 4%至 46%]、溶组织内阿米巴/迪斯帕内阿米巴 9%[95%CI 3%至 19%]和贾第虫 8%[95%CI 4%至 13%]）是最常见的肠道寄生虫。此外，我们发现 IPI 与孕妇贫血风险增加之间存在显著关联（OR 2.65[95%CI 2.08 至 3.37]）。与对照组相比，食土孕妇的 IPI 患病率略高，但差异无统计学意义（OR 1.22[95%CI 0.87 至 1.71]）。按物种分类，与对照组相比，食土孕妇感染蛔虫的 OR 更高（OR 2.66[95%CI 1.37 至 5.16]）。与城市居民相比，农村地区孕妇的 IPI 患病率较高（OR 3.36[95%CI 1.57 至 7.19]）。
本研究显示，孕妇的肠道寄生虫感染率相对较高，尤其是在一些中低收入国家。这些结果表明，需要加强预防和控制工作，以降低孕妇的健康风险。
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