Mofid Layla S, Casapía Martín, Montresor Antonio, Rahme Elham, Marquis Grace S, Vercruysse Jozef, Allen Lindsay H, Blouin Brittany, Razuri Hugo, Pezo Lidsky, Gyorkos Theresa W
Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada.
WHO Collaborating Centre for Research and Training in Parasite Epidemiology and Control, Montréal, Québec, Canada.
Matern Child Nutr. 2021 Oct;17(4):e13183. doi: 10.1111/mcn.13183. Epub 2021 Mar 17.
The World Health Organization recommends deworming to reduce soil-transmitted helminth (STH)-attributable morbidity in women of reproductive age, including pregnant and lactating women, to reduce blood loss, iron deficiency anaemia and nutrient malabsorption. This study assessed the impact of maternal postpartum deworming with albendazole approximately 1 day after delivery on infant milk intake among a subset of 216 randomly selected mother-infant pairs recruited into a large trial in Peru. Infant milk intake was measured using the deuterium-oxide method at 1- and 6-month postpartum. Maternal STH infection was measured at 6-month postpartum. At 1-month postpartum, mean intake was 756 ± 16 and 774 ± 18 mL day in the albendazole and placebo groups, respectively (mean difference: -18 mL day ; 95% CI: -65, 30). At 6-month postpartum, mean intake was 903 ± 16 and 908 ± 18 mL day in the albendazole and placebo groups, respectively (mean difference: -5 mL day ; 95% CI: -52, 43). There was no statistically significant difference in milk intake between groups at either time point. At 6-month postpartum, mothers infected with Trichuris trichiura had infants with higher milk intakes (adjusted mean difference: 70 mL day ; 95% CI: 20, 120) compared with uninfected mothers. However, there was no statistically significant difference in infant milk intake between mothers who had moderate-and-heavy intensity infection compared with the comparison group (mothers with no and light intensity infection). A lower prevalence and intensity of infection, and inclusion of uninfected mothers in both arms of the trial, resulting in effect dilution, may explain the null findings.
世界卫生组织建议进行驱虫治疗，以降低育龄妇女（包括孕妇和哺乳期妇女）因土壤传播的蠕虫（STH）感染而导致的发病率，从而减少失血、缺铁性贫血和营养吸收不良。本研究评估了在秘鲁一项大型试验中随机选取的216对母婴中，产妇在分娩后约1天服用阿苯达唑进行产后驱虫对婴儿奶量摄入的影响。在产后1个月和6个月时，采用氧化氘法测量婴儿奶量摄入。在产后6个月时测量产妇的STH感染情况。产后1个月时，阿苯达唑组和安慰剂组的平均奶量摄入量分别为756±16和774±18毫升/天（平均差值：-18毫升/天；95%置信区间：-65，30）。产后6个月时，阿苯达唑组和安慰剂组的平均奶量摄入量分别为903±16和908±18毫升/天（平均差值：-5毫升/天；95%置信区间：-52，43）。两个时间点两组之间的奶量摄入均无统计学显著差异。产后6个月时，感染鞭虫的母亲所生婴儿的奶量摄入量高于未感染母亲的婴儿（校正平均差值：70毫升/天；95%置信区间：20，120）。然而，与对照组（无感染和轻度感染的母亲）相比，中度和重度感染母亲所生婴儿的奶量摄入无统计学显著差异。感染的患病率和强度较低，且试验的两组中均纳入了未感染母亲，导致效应稀释，这可能解释了结果为阴性的原因。
