布基纳法索农村疟疾和可治愈性传播感染与妊娠结局的关联。

Association of malaria and curable sexually transmitted infections with pregnancy outcomes in rural Burkina Faso.

机构信息

Pôle d'Epidémiologie et biostatistique, Université catholique de Louvain (UCLouvain), Institut de Recherche Expérimentale et Clinique (IREC), Clos Chapelle-aux-Champs, 30 bte B1.30.13, 1200, Brussels, Belgique.

Institut de Recherche en Sciences de la Santé, Direction Régionale du Centre Ouest (IRSS/DRCO), Nanoro, Burkina Faso.

出版信息

BMC Pregnancy Childbirth. 2021 Oct 27;21(1):722. doi: 10.1186/s12884-021-04205-6.

DOI:10.1186/s12884-021-04205-6

PMID:34706705

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8549350/

Abstract

BACKGROUND

Malaria and curable sexually transmitted infections (STIs) are severe infections associated with poor pregnancy outcomes in sub-Saharan countries. These infections are responsible for low birth weight, preterm birth, and miscarriage. In Burkina Faso, many interventions recommended by the World Health Organization were implemented to control the impact of these infections. After decades of intervention, we assessed the impact of these infections on pregnancy outcomes in rural setting of Burkina Faso.

METHODS

Antenatal care and delivery data of pregnant women attending health facilities in 2016 and 2017 were collected in two rural districts namely Nanoro and Yako, in Burkina Faso. Regression models with likelihood ratio test were used to assess the association between infections and pregnancy outcomes.

RESULTS

During the two years, 31639 pregnant women received antenatal care. Malaria without STI, STI without malaria, and their coinfections were reported for 7359 (23.3%), 881 (2.8 %), and 388 (1.2%) women, respectively. Low birth weight, miscarriage, and stillbirth were observed in 2754 (10.5 %), 547 (2.0 %), and 373 (1.3 %) women, respectively. Our data did not show an association between low birth weight and malaria [Adjusted OR: 0.91 (0.78 - 1.07)], STIs [Adjusted OR: 0.74 (0.51 - 1.07)] and coinfection [Adjusted OR: 1.15 (0.75 - 1.78)]. Low birth weight was strongly associated with primigravidae [Adjusted OR: 3.53 (3.12 - 4.00)]. Both miscarriage and stillbirth were associated with malaria [Adjusted OR: 1.31 (1.07 - 1.59)], curable STI [Adjusted OR: 1.65 (1.06 - 2.59)], and coinfection [Adjusted OR: 2.00 (1.13 - 3.52)].

CONCLUSION

Poor pregnancy outcomes remained frequent in rural Burkina Faso. Malaria, curable STIs, and their coinfections were associated with both miscarriage and stillbirth in rural Burkina. More effort should be done to reduce the proportion of pregnancies lost associated with these curable infections by targeting interventions in primigravidae women.

摘要

背景

疟疾和可治愈的性传播感染（STIs）是撒哈拉以南非洲国家与不良妊娠结局相关的严重感染。这些感染可导致低出生体重、早产和流产。在布基纳法索，世界卫生组织推荐了许多干预措施来控制这些感染的影响。经过几十年的干预，我们评估了这些感染对布基纳法索农村地区妊娠结局的影响。

方法

收集了 2016 年和 2017 年在布基纳法索两个农村地区（纳诺罗和亚科）接受医疗保健的孕妇的产前保健和分娩数据。使用似然比检验的回归模型评估感染与妊娠结局之间的关联。

结果

在这两年中，共有 31639 名孕妇接受了产前保健。报告了 7359 例（23.3%）无 STI 的疟疾、881 例（2.8%）无疟疾的 STI 和 388 例（1.2%）混合感染。低出生体重、流产和死胎分别发生在 2754 例（10.5%）、547 例（2.0%）和 373 例（1.3%）孕妇中。我们的数据没有显示低出生体重与疟疾[调整后的比值比（OR）：0.91（0.78-1.07）]、性传播感染[调整后的 OR：0.74（0.51-1.07）]和混合感染[调整后的 OR：1.15（0.75-1.78）]之间存在关联。低出生体重与初产妇高度相关[调整后的 OR：3.53（3.12-4.00）]。流产和死胎均与疟疾[调整后的 OR：1.31（1.07-1.59）]、可治愈性 STI[调整后的 OR：1.65（1.06-2.59）]和混合感染[调整后的 OR：2.00（1.13-3.52）]相关。