Okoroafor Chigozie F, Umeononihu Osita S, Anikwe Chidebe C, Adebayo Adeniyi J, Ezeigwe Chijioke O, Olaleye Ayodele A, Okorochukwu Bartholomew C, Ogelle Onyechrelam M, Eleje George U
Department of Obstetrics & Gynaecology, Alex Ekwueme Federal University Teaching Hospital Abakaliki, P.M. B 102, Abakaliki, West Africa, Ebonyi State, Nigeria.
Department of Obstetrics & Gynaecology, Nnamdi Azikiwe University Teaching Hospital Nnewi, Anambra state, P.M.B 5025, Nnewi, West Africa, Nigeria.
BMC Pregnancy Childbirth. 2024 Dec 26;24(1):864. doi: 10.1186/s12884-024-07064-z.
Schistosomiasis, a neglected tropical disease, affects approximately 40 million women of reproductive age contributing to preventable anaemia during pregnancy, intrauterine growth retardation and low birth weight. In spite of the high prevalence rate of this disease among school aged children in Abakaliki, no study in Abakaliki has looked at the burden of Schistosomal infection in pregnancy with a view to determining maternal and neonatal outcomes.
To determine the association between schistosomal infection and maternal anemia, low birth weight, and other neonatal outcomes in Abakaliki.
This was a prospective cohort study involving 94 randomly selected pregnant women with schistosomal infection and 94 matched controls without schistosomal infection. Pregnant women included were at 34 to 36 weeks of gestation. The Kato-Katz technique was used for identification and quantification of the S. mansoni, and S. japonicum, parasites in the stool, while the Ziel-Neilson stain was used for detection of the S. haematobium parasites in the urine. The patients were followed up until delivery to determine maternal and neonatal outcomes. The data were analysed using IBM SPSS version 20. The level of significance is at P - value < 0.05.
The prevalence of schistosomiasis in the study area was (94/968) 9.71%. The predominant species identified was Schistosoma haematobium (61/94; 64.9%). Nulliparous women were more likely to have heavy schistosomiasis infections than multiparous women (OR 6.09, 95% CI 2.3 - 15.68; P =0.0001). Neonates of women infected with schistosomiasis had low birth weight compared with the control group (2.91 ±0.70kg vs. 3.20±0.60kg, P = 0.002). Placental mass was lower in cohort of women with the disease compared with the control (0.49±0.08kg vs. 0.52±0.09kg, P = 0.02). All the cohort of women with schistosomiasis were anaemic (28±1.9 vs. 30 ±2.1, P = < 0.0001). Burden of maternal anaemia was very high among cohort with heavy infection compared with those that had light infection (OR = 2.4 95%CI1.02-5.9, P = 0.04). Schistosoama haematobium infection was more likely to cause lower maternal haematocrit levels than Schistosoama mansoni infection was (OR 4.72 95% CI 1.87-11.95, P < 0.001).
Schistosomiasis in pregnancy is associated with adverse maternal and neonatal outcomes. S. haematobium was more likely to cause maternal anaemia than S. mansoni. We recommend routine antenatal screening of Schistosomiasis infection in the study area and the need to consider routine administration of praziquantel to antenatal attendee in the study area.
血吸虫病是一种被忽视的热带疾病，影响着约4000万育龄妇女，导致孕期出现可预防的贫血、胎儿宫内生长受限和低出生体重。尽管阿巴卡利基学龄儿童中这种疾病的患病率很高，但阿巴卡利基尚无研究关注孕期血吸虫感染的负担，以确定母婴结局。
确定阿巴卡利基血吸虫感染与孕产妇贫血、低出生体重及其他新生儿结局之间的关联。
这是一项前瞻性队列研究，纳入94例随机选取的感染血吸虫的孕妇及94例匹配的未感染血吸虫的对照。纳入的孕妇孕周为34至36周。采用加藤厚涂片法鉴定和定量粪便中的曼氏血吸虫和日本血吸虫寄生虫，采用齐尔-尼尔森染色法检测尿液中的埃及血吸虫寄生虫。对患者进行随访直至分娩，以确定母婴结局。使用IBM SPSS 20版软件进行数据分析。显著性水平为P值<0.05。
研究区域血吸虫病患病率为（94/968）9.71%。鉴定出的主要虫种为埃及血吸虫（61/94；64.9%）。初产妇比经产妇更易发生重度血吸虫感染（比值比6.09，95%可信区间2.3 - 15.68；P =0.0001）。与对照组相比，感染血吸虫的妇女所生新生儿出生体重较低（2.91±0.70kg对3.20±0.60kg，P = 0.002）。患病妇女队列的胎盘重量低于对照组（0.49±0.08kg对0.52±0.09kg，P = 0.02）。所有感染血吸虫的妇女队列均贫血（28±1.9对30 ±2.1，P = < 0.0001）。与轻度感染队列相比，重度感染队列中孕产妇贫血负担非常高（比值比 = 2.4，95%可信区间1.02 - 5.9，P = 0.04）。与曼氏血吸虫感染相比，埃及血吸虫感染更易导致孕产妇血细胞比容水平降低（比值比4.72，95%可信区间1.87 - 11.95，P < 0.001）。
孕期血吸虫病与不良母婴结局相关。与曼氏血吸虫相比，埃及血吸虫更易导致孕产妇贫血。我们建议在研究区域对血吸虫感染进行常规产前筛查，并考虑对研究区域的产前检查者常规给予吡喹酮治疗。
