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Trypanosoma cruzi Infection in Pregnancies without Congenital Transmission Is Associated with Reduced Fetal Growth: A Cross-Sectional Study in Argentina, Honduras, and Mexico.
- Source :
-
The American journal of tropical medicine and hygiene [Am J Trop Med Hyg] 2024 Jun 04; Vol. 111 (1), pp. 64-72. Date of Electronic Publication: 2024 Jun 04 (Print Publication: 2024). - Publication Year :
- 2024
-
Abstract
- We aimed to measure the association between Trypanosoma cruzi infection in pregnancy and reduced fetal growth in the absence of T. cruzi congenital transmission. We conducted a cross-sectional study of secondary data of all singleton live births between 2011 and 2013 in five hospitals from Argentina, Honduras, and Mexico. We excluded newborns with T. cruzi infection. Noninfected pregnant people were those without any positive rapid tests. The main study outcomes were birth weight, head circumference, and length for gestational age and sex. Logistic regression models were adjusted for country, age, education level, and obstetric history. Of the 26,544 deliveries, 459 (1.7%) pregnant people were found by rapid tests to be positive for T. cruzi. Of these, 320 were positive by enzyme-linked immunosorbent assay and 231 had a positive polymerase chain reaction (PCR) test. Uninfected newborns from T. cruzi-infected pregnant people were more likely to have birth weights below the 5th and 10th percentiles and head circumferences below the 3rd and 10th percentiles. Among T. cruzi-infected pregnant people diagnosed by PCR, the odds ratios were 1.58 for birth weight below the 10th percentile (95% CI, 1.12-2.23) and 1.57 for birth weight below the 5th percentile (95% CI, 1.02-2.42). Higher T. cruzi parasitic loads in pregnancy had a stronger association with reduced fetal growth (both in birth weight and head circumference), with an odds ratio of 2.31 (95% CI, 1.36-3.91) for a birth weight below the 5th percentile. The association shows, irrespective of causality, that newborns of pregnancies with T. cruzi have an increased risk of reduced fetal growth. We recommend further studies to assess other potential confounders and the causality of these associations.
- Subjects :
- Humans
Female
Pregnancy
Cross-Sectional Studies
Honduras epidemiology
Argentina epidemiology
Adult
Mexico epidemiology
Infant, Newborn
Pregnancy Complications, Parasitic epidemiology
Male
Young Adult
Fetal Growth Retardation epidemiology
Fetal Growth Retardation parasitology
Fetal Development
Chagas Disease transmission
Chagas Disease epidemiology
Chagas Disease congenital
Trypanosoma cruzi isolation & purification
Birth Weight
Subjects
Details
- Language :
- English
- ISSN :
- 1476-1645
- Volume :
- 111
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- The American journal of tropical medicine and hygiene
- Publication Type :
- Academic Journal
- Accession number :
- 38834059
- Full Text :
- https://doi.org/10.4269/ajtmh.23-0493