The effect of chronic intestinal parasitic infection on maternal and perinatal outcome.
OBJECTIVE
The main objective of this prospective cohort study was to investigate the prevalence, risk factors and maternal-perinatal consequences of chronic asymptomatic intestinal parasitic infection during pregnancy.


METHODS
Prenatal patients (n=91) attending a public clinic in Quito, Ecuador, were followed during the third trimester. Intestinal parasitic, nutritional status, sociodemographic/sanitation indicators and fetal outcome data were collected and analyzed using multivariate ANOVA and regression techniques.


RESULTS
Most subjects (93%) were infected with at least one species of pathogenic intestinal parasite: 88% with Entamoeba histolytica. Greater parasite burdens were associated with poorer maternal iron status and reduced fetal growth. In particular, a high E. histolytica load was associated with decreased maternal serum hemoglobin (P=0.002) and hematocrit levels (P=0.01), iron deficiency anemia (P=0.026), and indicators of diminished intrauterine growth including a decreased ponderal index (P=0.04), mid-arm circumference (P=0.01), and mid-arm/head circumference ratio (P=0.003).


CONCLUSIONS
Asymptomatic intestinal parasitic infection represents a hidden risk factor for maternal iron deficiency anemia and fetal growth retardation.
Weigel
M M
MM
Laboratorio de Inmunología, Facultad de Ciencias Médicas, Universidad Central de Ecuador, Quito.
Calle
A
A
Armijos
R X
RX
Vega
I P
IP
Bayas
B V
BV
Montenegro
C E
CE
D000328:Adult; D018798:Anemia, Iron-Deficiency / Q000453:epidemiology; D000818:Animals; D002908:Chronic Disease; D004484:Ecuador / Q000453:epidemiology; D004748:Entamoeba histolytica; D005260:Female; D005317:Fetal Growth Retardation / Q000453:epidemiology; D006801:Humans; D007411:Intestinal Diseases, Parasitic / Q000150:complications* / Q000453:epidemiology / Q000469:parasitology; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic / Q000453:epidemiology / Q000469:parasitology; D011256:Pregnancy Outcome; D011446:Prospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors