In this short blog post we draw attention to schistosomiasis and its links to premature birth, in recognition of World Prematurity Day.
Researchers at Brown University in the United States are looking at schistosomiasis and its effects on pregnant women in Leyte, a community in the Philippines. As a quick reminder for those who have not been following our growing interest in this insidious fluke, schistosomiasis is a water-borne parasite that wreaks havoc on internal organs, depending upon its strain.
Schisto-h affects the reproductive organs, while schisto-j affects the liver and is perhaps the most insidious. Though the effects of schistosomiasis have been studied for years, intense examination of its health effects on mother and fetus during pregnancy have somehow been neglected in much research until recently.
Friedman and Kurtis and their team are finding a link between schisto-j, placental inflammation and adverse birth outcomes, including prematurity in the population in Leyte, Philippines. Mothers who have schistosomiasis-j have higher levels of endotoxemia (1.3 times in maternal blood, 2.4 times higher in the placenta). Endotoxins are in turn, associated with prematurity. The Brown team has found that in pregnancy, schisto-j eggs also have proinflammatory response, also associated with prematurity and other adverse pregnancy events including intrauterine growth restriction and low birthweight.
Put in layman's terms, the schistosomiasis eggs cause a chronic infection and a long-term inflammatory response which is linked to problems in the placenta as well as in the maternal bloodstream.
But how big a problem is it potentially? Schistosomiasis affects some 200 million people worlwide, 40 million women of reproductive age. Schisto-j is endemic in countries with huge populations: China, The Philippines and Indonesia. Suffice it to say, that the problem is large and further exploration of the troublesome fluke in all its forms is important for women's health and for the prevention of prematurity.
Identification of anemia in pregnant women is important, since it is an important cause of multiple complications during pregnancy (preterm delivery, low birth weight and perinatal death), so it is recommended to all pregnant women, in the first prenatal visit and at 28 weeks of gestation, the measurement of serum concentrations of hemoglobin and hematocrit as a screening test for anemia.
Prenatal assessment seeks to identify, through clinical history, sociodemographic characteristics, mean blood pressure, Doppler of the uterine arteries and biochemical markers such as pregnancy-associated plasma protein A (PAPP-A) and placental growth factor (PlGF), those women who are at high risk of developing preeclampsia in order to take appropriate measures. that can help reduce that risk.