Lack of Risk of Adverse Birth Outcomes After Deworming in Pregnant Women

Gyorkos, Theresa W.; Larocque, Renée; Casapía, Martín; Gotuzzo, Eduardo

doi:10.1097/01.inf.0000234068.25760.97

Cited by 60 publications

(40 citation statements)

References 13 publications

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“…Parallel studies are examining the added benefits of micronutrient supplementation, particularly in combating the anemias associated with hookworm and schistosomiasis (148,149). Other studies are specifically examining the impact of infection among women who are pregnant and women of child-bearing age, risk groups who are often excluded from MDA because of fears of fetal toxicity (136,150,151), or they are examining the early developmental effects of helminthic infections among preschool children (152). Despite the evident success of MDA, limitations have been observed in the effectiveness of treatment in some field settings, and concern has been raised about the potential for emergence of resistance to the mainstay drugs of MDA programs, including the benzimidazole anthelminthic, used predominantly to combat soil-transmitted helminth infections, and ivermectin, which is used to combat filarial infections (146,(153)(154)(155)(156)(157)(158).…”

Section: Global Control Of Helminthiases and Clinical Research Imperamentioning

confidence: 99%

Helminth infections: the great neglected tropical diseases

et al. 2008

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Helminths are parasitic worms. They are the most common infectious agents of humans in developing countries and produce a global burden of disease that exceeds better-known conditions, including malaria and tuberculosis. As we discuss here, new insights into fundamental helminth biology are accumulating through newly completed genome projects and the nascent application of transgenesis and RNA interference technologies. At the same time, our understanding of the dynamics of the transmission of helminths and the mechanisms of the Th2-type immune responses that are induced by infection with these parasitic worms has increased markedly. Ultimately, these advances in molecular and medical helminth biology should one day translate into a new and robust pipeline of drugs, diagnostics, and vaccines for targeting parasitic worms that infect humans.

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Section: Global Control Of Helminthiases and Clinical Research Imperamentioning

confidence: 99%

Helminth infections: the great neglected tropical diseases

et al. 2008

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“…7,8,13,14 Indeed, there is an expanding evidence base to support use of antenatal anthelminthic treatment in the second or third trimester with either albendazole or mebendazole given that the risks of hookworm in pregnancy appear to outweigh potential toxicities noted in preclinical animal testing with these medications. 15,16 However, in other settings, including a study of more than 2,000 pregnant women in Uganda with low-intensity helminth infections, there was no overall benefit of using of anthelminthics during pregnancy, 17 and there was even an increased risk of infantile eczema among newborns. 18 In the systematic review published in 2008, there were insufficient data to confirm the benefits of deworming on anemia in pregnancy, 6 but gradually and cautiously the global health community is moving toward extending coverage of anthelminthic treatment to pregnant women, especially in areas where pharmacovigilance can be assured.…”

Section: Hookworm Infection and Pregnancymentioning

confidence: 92%

Helminth Infections

Hotez

Whitham

2014

Obstetrics &Amp; Gynecology

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Emerging evidence over the past decade has implicated helminth infections as important yet stealth causes of adverse pregnancy outcomes and impaired women's reproductive health. The two most important helminth infections affecting women living in poverty in Africa and elsewhere in the developing world are hookworm infection and schistosomiasis. In Africa alone, almost 40 million women of childbearing age are infected with hookworms, including almost 7 million pregnant women who are at greater risk of severe anemia, higher mortality, and experiencing poor neonatal outcome (reduced birth weight and increased infant mortality). Possibly, tens of millions of women in Africa also suffer from female genital schistosomiasis associated with genital itching and pain, stress incontinence, dyspareunia, and infertility and experience social stigma and depression. Female genital schistosomiasis also is linked to horizontal transmission of human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) and it may represent one of Africa's major cofactors in its AIDS epidemic. There is urgency to expand mass drug administration efforts for hookworm and schistosomiasis to include women of reproductive age and to shape new policies and advocacy initiatives for women's global health to include helminth control. In parallel is a requirement to better link global health programs for HIV and AIDS and malaria with helminth control and to simultaneously launch initiatives for research and development.

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“…However, neither study determined infection status either before or after treatment, and both may have been confounded by factors affecting which women received treatment in the first place. In three randomized trials, treatment had no significant effect on perinatal mortality 5,65,69,70…”

Section: Perinatal Mortalitymentioning

confidence: 97%

Helminth infection during pregnancy: insights from evolutionary ecology

Blackwell

2016

IJWH

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Helminths are parasitic nematodes and trematodes, grouped together because of morphological similarities and commonalities in the effects infections have on hosts. These include complications such as anemia and biasing of immune responses, which can alter susceptibility for other diseases. For pregnant women, these complications might have implications for pregnancy outcomes or neonatal health. Here, I review studies of helminth infections during pregnancy, and ask the following questions: Do helminths affect maternal health or pregnancy outcomes? Are there consequences of maternal infection for infants? What are the effects of antihelminth treatment during pregnancy? The evidence suggests that the answers to these questions depend on the particular helminth species in question, maternal nutritional status, and the presence or absence of comorbid infection with other species, such as malaria. Moreover, there may also be unexpected consequences of treatment, as maternal infections can affect the priming of infant immune systems, with potential effects on infants later in life. These complex interactions suggest that a consideration of the evolutionary history of human–helminth interactions, as well as the ecological context of infections, can help to clarify an understanding of these host–parasite interactions and provide direction for future investigations.

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Lack of Risk of Adverse Birth Outcomes After Deworming in Pregnant Women

Abstract: The evidence provided by this large randomized, controlled trial of mebendazole administered during pregnancy indicates that deworming with mebendazole can be safely included in antenatal care programs in hookworm-endemic areas.

Cited by 60 publications

References 13 publications

Helminth infections: the great neglected tropical diseases

Helminth infections: the great neglected tropical diseases

Helminth Infections

Helminth infection during pregnancy: insights from evolutionary ecology

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