title: A Double-Blind Randomized Controlled Trial of Maternal Postpartum Deworming to Improve Infant Weight Gain in the Peruvian Amazon.
abstract: Nutritional interventions targeting the critical growth and development period before two years of age can have the greatest impact on health trajectories over the life course. Compelling evidence has demonstrated that interventions investing in maternal health in the first 1000 days of life are beneficial for both mothers and their children. One such potential intervention is deworming integrated into maternal postpartum care in areas where soil-transmitted helminth (STH) infections are endemic.
  
  
  
  From February to August 2014, 1010 mother-infant pairs were recruited into a trial aimed at assessing the effectiveness of maternal postpartum deworming on infant and maternal health outcomes. Following delivery, mothers were randomly assigned to receive either single-dose 400 mg albendazole or placebo. Participants were followed-up at 1 and 6 months postpartum. There was no statistically significant difference in mean weight gain between infants in the experimental and control groups (mean difference: -0.02; 95% CI: -0.1, 0.08) at 6 months of age. Further, deworming had no effect on measured infant morbidity indicators. However, ad hoc analyses restricted to mothers who tested positive for STHs at baseline suggest that infants of mothers in the experimental group had greater mean length gain in cm (mean difference: 0.8; 95% CI: 0.1, 1.4) and length-for-age z-score (mean difference: 0.5; 95% CI: 0.2, 0.8) at 6 months of age.
  
  
  
  In a study population composed of both STH-infected and uninfected mothers, maternal postpartum deworming was insufficient to impact infant growth and morbidity indicators up to 6 months postpartum. Among STH-infected mothers, however, important improvements in infant length gain and length-for-age were observed. The benefits of maternal postpartum deworming should be further investigated in study populations having higher overall prevalences and intensities of STH infections and, in particular, where whipworm and hookworm infections are of public health concern.
  
  
  
  ClinicalTrials.gov (NCT01748929).
authors.affiliation: Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada.|Division of Clinical Epidemiology, Research Institute of the McGill University Health Centre, Montréal, Québec, Canada.
authors.forename: Layla S
authors.initials: LS
authors.lastname: Mofid
authors.affiliation: Asociación Civil Selva Amazónica, Iquitos, Peru.
authors.forename: Martín
authors.initials: M
authors.lastname: Casapía
authors.affiliation: Hospital Iquitos "César Garayar García", Iquitos, Peru.
authors.forename: Eder
authors.initials: E
authors.lastname: Aguilar
authors.affiliation: Hospital Iquitos "César Garayar García", Iquitos, Peru.
authors.forename: Hermánn
authors.initials: H
authors.lastname: Silva
authors.affiliation: Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland.
authors.forename: Antonio
authors.initials: A
authors.lastname: Montresor
authors.affiliation: Division of Clinical Epidemiology, Research Institute of the McGill University Health Centre, Montréal, Québec, Canada.|Department of Medicine, McGill University, Montréal, Québec, Canada.
authors.forename: Elham
authors.initials: E
authors.lastname: Rahme
authors.affiliation: Centre de recherche et Département d'obstétrique et de gynécologie, Université de Sherbrooke, Sherbrooke, Québec, Canada.
authors.forename: William D
authors.initials: WD
authors.lastname: Fraser
authors.affiliation: School of Dietetics and Human Nutrition, McGill University, Ste. Anne-de-Bellevue, Québec, Canada.
authors.forename: Grace S
authors.initials: GS
authors.lastname: Marquis
authors.affiliation: Department of Virology, Parasitology and Immunology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
authors.forename: Jozef
authors.initials: J
authors.lastname: Vercruysse
authors.affiliation: USDA, ARS Western Human Nutrition Research Center, University of California, Davis, California, United States of America.
authors.forename: Lindsay H
authors.initials: LH
authors.lastname: Allen
authors.affiliation: Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada.|Division of Clinical Epidemiology, Research Institute of the McGill University Health Centre, Montréal, Québec, Canada.
authors.forename: Brittany
authors.initials: B
authors.lastname: Blouin
authors.affiliation: Division of Clinical Epidemiology, Research Institute of the McGill University Health Centre, Montréal, Québec, Canada.
authors.forename: Hugo
authors.initials: H
authors.lastname: Razuri
authors.affiliation: Asociación Civil Selva Amazónica, Iquitos, Peru.
authors.forename: Lidsky
authors.initials: L
authors.lastname: Pezo
authors.affiliation: Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Québec, Canada.|Division of Clinical Epidemiology, Research Institute of the McGill University Health Centre, Montréal, Québec, Canada.
authors.forename: Theresa W
authors.initials: TW
authors.lastname: Gyorkos
mesh_terms: D000328:Adult; D015766:Albendazole / Q000008:administration & dosage*; D000871:Anthelmintics / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006373:Helminthiasis / Q000188:drug therapy* / Q000469:parasitology / Q000503:physiopathology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000188:drug therapy* / Q000469:parasitology / Q000503:physiopathology; D008297:Male; D009035:Mothers; D010568:Peru; D049590:Postpartum Period; D015430:Weight Gain / Q000187:drug effects*; D055815:Young Adult
chemical_list: D000871:Anthelmintics; D015766:Albendazole