Abstract
.Little is known about the effect of helminth infections on the natural gynecological and pregnancy course. Our goal was to assess the relationship between Wuchereria bancrofti and hookworm (HW) infections with pregnancy course and outcome in a group of 82 women living in a rural area of the Democratic Republic of the Congo. Demographics and information on gynecological and obstetrical histories were collected retrospectively with standardized questionnaires. Wuchereria bancrofti and HW infections were diagnosed using a filarial antigen-detection test and the Kato–Katz method, respectively. Analyses consisted of multivariable logistic regressions adjusting for age, number of deliveries, and history of anthelmintic treatment (HAHT). The median age of study participants was 35 (interquartile range [IQR]: 30–44) years, and the median number of deliveries was five (IQR: 3–7). Wuchereria bancrofti and HW infection rates were 44.5% and 43.3%, respectively. Filarial antigenemia and HW infection were not significantly associated with the number of deliveries. The proportions of women with a history of pregnancy resulting in neonatal death, miscarriage, premature birth, and postpartum hemorrhage were 56%, 44%, 23%, and 36%, respectively. History of pregnancy associated with neonatal death was less frequent in women with HAHT, tended to be more frequent in women with filarial antigenemia, and was not associated with HW infection. None of the three other pregnancy events studied (miscarriage, premature birth, and postpartum hemorrhage) were associated with filarial antigenemia or HW infection. The positive association found between HAHT and lower risk of neonatal death warrants investigation in larger groups of women.
Highlights
Many infectious diseases can cause infertility in males or females, as well as lead to adverse pregnancy outcomes.[1,2,3] Infertility, defined as “a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse,”[4] can arise because of “male factors”, female factors, or both
Our goal was to assess the relationship between Wuchereria bancrofti and hookworm (HW) infections with pregnancy course and outcome in a group of 82 women living in a rural area of the Democratic Republic of the Congo
The aim of the present study was to document, for the first time, pregnancy outcomes in a rural population of Democratic Republic of the Congo (DRC), and assess whether pregnancy outcomes were related to HW or LF parasitological status
Summary
Many infectious diseases can cause infertility in males or females, as well as lead to adverse pregnancy outcomes.[1,2,3] Infertility, defined as “a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse,”[4] can arise because of “male factors” (such as alterations in sperm concentration and/or motility and/or morphology), female factors, or both. The most common causes of female infertility are ovulatory disorders, tubal occlusion or abnormalities, pelvic adhesions, and endometriosis. Can induce hormonal imbalances and dysregulation associated with infertility.[10] Infertility was found to be significantly associated with residence in areas of high S. haematobium prevalence in East Africa.[11] Adult stages of the filarial worm Wuchereria bancrofti (the main cause of lymphatic filariasis [LF]) have been found in nodules or lymphatics of the genital tract, where they have been shown to lead to salpingitis, blockage of the fallopian
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