Walia Bhavneet, Kmush Brittany L, Lane Sandra D, Endy Timothy, Montresor Antonio, Larsen David A
Syracuse University Department of Public Health, Syracuse, New York, United States of America.
State University of New York Upstate Medical University Department of Infectious Disease, Syracuse, New York, United States of America.
PLoS Negl Trop Dis. 2021 Apr 29;15(4):e0009282. doi: 10.1371/journal.pntd.0009282. eCollection 2021 Apr.
Soil transmitted helminths (STH) are a common infection among pregnant women in areas with poor access to sanitation. Deworming medications are cheap and safe; however, the health benefit of deworming during pregnancy is not clear.
METHODS / PRINCIPAL FINDINGS: We created a retrospective cohort of more than 800,000 births from 95 Demographic and Health Survey datasets to estimate the impact of deworming medicine during routine antenatal care (ANC) on neonatal mortality and low birthweight. We first matched births on the probability of receiving deworming during ANC. We then modeled the birth outcomes with the matched group as a random intercept to estimate the effect of deworming during antenatal care after accounting for various risk factors. We also tested for effect modification of soil transmitted helminth prevalence on the impact of deworming during ANC. Receipt of deworming medication during ANC was associated with a 14% reduction in the risk of neonatal mortality (95% confidence interval = 10-17%, n = 797,772 births), with no difference between high and low transmission countries. In low transmission countries, we found an 11% reduction in the odds of low birth weight (95% confidence interval = 8-13%) for women receiving deworming medicine, and in high transmission countries, we found a 2% reduction in the odds of low birthweight (95% confidence interval = 0-5%).
CONCLUSIONS / SIGNIFICANCE: These results suggest a substantial health benefit for deworming during ANC that may be even greater in countries with low STH transmission.
在卫生设施匮乏地区，土壤传播性蠕虫（STH）感染在孕妇中很常见。驱虫药物价格低廉且安全；然而，孕期驱虫对健康的益处尚不清楚。
方法/主要发现：我们从95个 Demographic and Health Survey 数据集创建了一个超过80万例出生的回顾性队列，以评估常规产前护理（ANC）期间驱虫药物对新生儿死亡率和低出生体重的影响。我们首先根据ANC期间接受驱虫的概率对出生情况进行匹配。然后，我们将匹配组作为随机截距对出生结局进行建模，以估计在考虑各种风险因素后产前护理期间驱虫的效果。我们还测试了土壤传播性蠕虫流行率对ANC期间驱虫影响的效应修正。ANC期间接受驱虫药物与新生儿死亡风险降低14%相关（95%置信区间 = 10 - 17%，n = 797,772例出生），高传播国家和低传播国家之间无差异。在低传播国家，我们发现接受驱虫药物的女性低出生体重几率降低11%（95%置信区间 = 8 - 13%），在高传播国家，我们发现低出生体重几率降低2%（95%置信区间 = 0 - 5%）。
结论/意义：这些结果表明，ANC期间驱虫对健康有显著益处，在STH传播率低的国家可能更大。
