title: Trichuris and hookworm infections associated with anaemia during pregnancy.
abstract: OBJECTIVE
  To assess the following associations between the second and third trimesters of pregnancy: (i) the intensity of soil-transmitted helminth (STH) infection and haemoglobin/anaemia, (ii) the effect of mebendazole treatment on the occurrence of STH infection, and (iii) the effect of mebendazole treatment on haemoglobin/anaemia.
  
  
  METHODS
  Data originated from a trial of 1042 pregnant women recruited in their second trimester and followed to delivery. Baseline assessments included socio-demographic/health information from questionnaires, haemoglobin/anaemia from HemoCue ascertainment of fingerprick blood, and the presence and intensity of STH (Ascaris lumbricoides, hookworms and Trichuris trichiura) infections from Kato-Katz examination. All women were given iron supplements; half were randomly allocated to receive single dose 500 mg mebendazole, and half, placebo. Haemoglobin/anaemia and STH infection status were determined again in the third trimester of pregnancy.
  
  
  RESULTS
  Complete information was available from 935 (89.7%) women. Mebendazole significantly reduced the prevalence and intensity of all three STH infections. Higher intensities of hookworm and Trichuris infections in the second trimester were associated with a higher risk of anaemia in the third trimester. Overall, women with moderate/heavy Trichuris infection were found to be at a higher risk of anaemia; the highest risk was observed among those with moderate/heavy hookworm co-infection (adjusted OR = 2.77; 95% CI: 1.26, 6.11). Mebendazole treatment did not reduce the risk of anaemia.
  
  
  CONCLUSIONS
  Higher intensities of both Trichuris and hookworm infections are associated with anaemia in pregnancy. The importance of Trichuris infections during pregnancy requires renewed attention.
authors.affiliation: Division of Clinical Epidemiology, Department of Epidemiology, Biostatistics and Occupational Health, Research Institute of the McGill University Health Centre, McGill University, Montréal, QC, Canada. theresa.gyorkos@mcgill.ca
authors.forename: Theresa W
authors.initials: TW
authors.lastname: Gyorkos
authors.forename: Nicolas L
authors.initials: NL
authors.lastname: Gilbert
authors.forename: Renée
authors.initials: R
authors.lastname: Larocque
authors.forename: Martín
authors.initials: M
authors.lastname: Casapía
mesh_terms: D000293:Adolescent; D000328:Adult; D000740:Anemia / Q000469:parasitology*; D000818:Animals; D000969:Antinematodal Agents / Q000627:therapeutic use; D001196:Ascariasis / Q000150:complications* / Q000517:prevention & control; D017164:Ascaris lumbricoides; D005260:Female; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D008463:Mebendazole / Q000627:therapeutic use; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000469:parasitology*; D015597:Pregnancy Complications, Parasitic / Q000517:prevention & control*; D011295:Prenatal Care / Q000379:methods; D012959:Socioeconomic Factors; D016896:Treatment Outcome; D014257:Trichuriasis / Q000150:complications* / Q000517:prevention & control
chemical_list: D000969:Antinematodal Agents; D006454:Hemoglobins; D008463:Mebendazole