Infecções parasitárias intestinais e efeitos adversos em grávidas e seus recém-nascidos em São Tomé e Príncipe: um estudo transversal hospitalar
Resumo
Introdução: A associação entre infecções parasitárias intestinais (IPI) e resultados adversos da gravidez (ABO) permanece pouco esclarecida, existindo lacunas relevantes de conhecimento. Este estudo teve como objetivo avaliar o impacto das IPI em díades materno-neonatais em São Tomé e Príncipe.
Material e Métodos: Realizou-se um estudo transversal de base hospitalar em grávidas internadas para parto, submetidas a rastreio coproparastiológico durante a gravidez. Foram excluídas as grávidas com infeção por VIH, doença falciforme, malária ou tratamento anti-helmíntico recente. Os dados foram obtidos a partir dos boletins pré-natais, registos neonatais e questionários estruturados. Compararam-se os ABO entre o grupo infectado (n=210) e o grupo não infectado (n=151). As análises de subgrupos incluíram infecções combinadas por helmintas (n=202; 90,9% ascaris lumbricoides), Schistosoma intercalatum (n=11) e Entamoeba histolytica (n=7). Foi considerado valor de p<0,05 como estatisticamente significativo.
Resultados: Foram incluídas 361 mulheres (idade média 26,96 anos; DP 7,00). A anemia ocorreu em 39,6% (n=127), a prematuridade em 8,1% (n=26), o baixo peso à nascença (BPN) em 14,9% (n=48) e o óbito fetal em 2,5% (n=8) dos casos. Não se observaram diferenças estatisticamente significativas nas taxas de anemia, prematuridade, BPN ou óbito fetal entre os grupos monoparasitado e não infectado (p=0,182; p=0,175; p=0,07; p=0,275, respetivamente). A prevalência de BPN foi inferior no grupo infectado por helmintas (11,7%) face ao grupo não infectado (19,2%), embora sem significância estatística (p=0,067).
Conclusões: Não foram identificados efeitos adversos significativos associados às IPI em mulheres grávidas. O Ascaris lumbricoides foi o parasita mais prevalente e observou-se uma tendência para menor incidência de BPN nas mulheres infectadas. O tratamento anti-helmíntico rotineiro durante a gravidez deve ser utilizado com precaução, dado que infecções assintomáticas podem conferir benefícios imunológicos. A persistência de esquistossomose indica que as declarações de eliminação são prematuras, sendo recomendada a quimioprofilaxia preventiva também em mulheres em idade reprodutiva.
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