Impact of Helminth Infection during Pregnancy on Cognitive and Motor Functions of One-Year-Old Children

ObjectiveTo determine the effect of helminth infection during pregnancy on the cognitive and motor functions of one-year-old children.MethodsSix hundred and thirty five singletons born to pregnant women enrolled before 29 weeks of gestation in a trial comparing two intermittent preventive treatments for malaria were assessed for cognitive and motor functions using the Mullen Scales of Early Learning, in the TOVI study, at twelve months of age in the district of Allada in Benin. Stool samples of pregnant women were collected at recruitment, second antenatal care (ANC) visit (at least one month after recruitment) and just before delivery, and were tested for helminths using the Kato-Katz technique. All pregnant women were administered a total of 600 mg of mebendazole (100 mg two times daily for 3 days) to be taken after the first ANC visit. The intake was not directly observed.ResultsPrevalence of helminth infection was 11.5%, 7.5% and 3.0% at first ANC visit, second ANC visit and at delivery, respectively. Children of mothers who were infected with hookworms at the first ANC visit had 4.9 (95% CI: 1.3–8.6) lower mean gross motor scores compared to those whose mothers were not infected with hookworms at the first ANC visit, in the adjusted model. Helminth infection at least once during pregnancy was associated with infant cognitive and gross motor functions after adjusting for maternal education, gravidity, child sex, family possessions, and quality of the home stimulation.ConclusionHelminth infection during pregnancy is associated with poor cognitive and gross motor outcomes in infants. Measures to prevent helminth infection during pregnancy should be reinforced.**研究目的**：明确妊娠期蠕虫感染对1岁龄儿童认知与运动功能的影响。 **研究方法**：本研究为TOVI研究的一部分，在贝宁阿拉达地区开展。共纳入妊娠29周前入组、参与两项疟疾间歇性预防治疗对比试验的单胎妊娠孕妇所生的635名单胎新生儿，于这些子代年满12月龄时，采用穆兰早期学习量表（Mullen Scales of Early Learning）评估其认知与运动功能。研究人员分别于孕妇入组时、首次产前保健（Antenatal Care, ANC）随访（入组至少1个月后）及临产前采集粪便样本，采用加藤-卡特（Kato-Katz）技术检测蠕虫感染。所有孕妇均被给予总剂量600mg的甲苯咪唑（每日2次，每次100mg，连服3日），要求于首次ANC随访后服用，但未直接观察服药依从性。 **研究结果**：在首次ANC随访、第二次ANC随访及临产前，孕妇蠕虫感染率分别为11.5%、7.5%与3.0%。校正模型显示，首次ANC随访时检出钩虫感染的孕妇所生子代，其粗大运动评分均值较未感染组低4.9分（95%置信区间：1.3~8.6）。在校正母亲教育程度、孕次、子代性别、家庭财产状况及家庭环境刺激质量后，妊娠期至少发生1次蠕虫感染与婴幼儿的认知功能及粗大运动功能存在关联。 **研究结论**：妊娠期蠕虫感染与婴幼儿较差的认知及粗大运动结局相关，应加强妊娠期蠕虫感染的预防干预措施。