Birthweight in Offspring of Mothers with High Prevalence of Helminth and Malaria Infection in Coastal Kenya

Abstract

Abstract. Results of studies on the associations of maternal helminth infection and malaria-helminth co-infection on birth outcomes have been mixed. A group of 696 pregnant women from the Kwale district in Kenya were recruited and tested for malaria and helminth infection at delivery. Birthweight was documented for 664 infants. A total of 42.7% of the mothers were infected with Plasmodium falciparum, 30.6% with Schistosoma haematobium, 36.2% with filariasis, 31.5% with hookworm, and 5.9% with Trichuris trichiura; co-infection was present in 46.7%. Low birthweight (LBW) (weight 2,500 grams) was present in 15.4% of the offspring, and 8.3% had a weight z-score 2 SD below the World Health Organization mean. Only gravida, age, and locale had a significant association with LBW. The high prevalence of maternal infection coupled with a higher than expected percentage of LBW highlight a need for further investigation of the association of maternal co-infection with LBW.

A cohort study of Plasmodium falciparum malaria in pregnancy and associations with uteroplacental blood flow and fetal anthropometrics in Kenya

“…From January 1, 2006, to December 31, 2009, the study team recruited pregnant women who attended prenatal care at Msambweni District Hospital, Msambweni, Coast Province, Kenya—a rural area where malaria is endemic [5]. Per Kenya Ministry of Health national policy, women received IPTp beginning in the second trimester, as well as iron, folic acid, and bed nets, as part of routine care.…”

“…Malaria in pregnancy causes low birth weight, a major contributor to neonatal mortality and morbidity worldwide [1–5]. In Sub‐Saharan Africa, where malaria is endemic, malaria in pregnancy may contribute to 25% of low birth weight [6].…”

Helminth infection during pregnancy: insights from evolutionary ecology

“…A study conducted in Guatemala City found that helminth and protozoa were associated with risk of small birth weight for gestational age, but only in undernourished women, with undernourishment determined based on maternal height 64. In contrast to these studies, other studies of helminths alone have found no association between infection and birth weight65 or have actually found that women with infections have higher birth weights even in the presence of coinfections 66…”

A case of strongyloidiasis in pregnancy

“…9 Though an association of low birth weight has been suggested with parasitic zoonoses, it has not been completely established. 10 Ivermectin, a macrocyclic lactone antibiotic is the most effective agent for management of this infection. 4 Though it is a potentially foetotoxic and embryotoxic agent, previous reports of its successful use in pregnancy with no adverse feto-maternal effects exist.…”