@article{fdi:010081090,
  title = {{S}oil-transmitted helminth infection in pregnancy and long-term child neurocognitive and behavioral development : a prospective mother-child cohort in {B}enin},
  author = {{G}arrison, {A}. and {B}oivin, {M}. and {K}hoshnood, {B}. and {C}ourtin, {D}avid and {A}lao, {J}. and {M}ireku, {M}. and {I}bikounle, {M}. and {M}assougbodji, {A}. and {C}ot, {M}ichel and {B}odeau-{L}ivinec, {F}.},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground {A}n estimated 30% of women in {S}ub-{S}aharan {A}frica suffer from soil-transmitted helminth infection during pregnancy ({SHIP}), which has been shown to increase risk of pre-term birth, low birth weight, and maternal anemia. {A} previous study in {B}enin found that {SHIP} was associated with impaired cognitive and gross motor development scores in 635 one-year-old children. {T}he objective of the present study was to follow children prospectively to investigate whether the association between {SHIP} and child neurocognitive and behavioral development persisted at age six. {P}rincipal findings {O}ur prospective child cohort included 487 live-born singletons of pregnant women enrolled in the {M}alaria in {P}regnancy {P}reventive {A}lternative {D}rugs clinical trial in {A}llada, {B}enin. {SHIP} was assessed at three antenatal visits ({ANV}s) through collection and testing of stool samples. {N}eurocognitive and behavioral development was assessed in six-year-old children by trained investigators using the {K}aufman {A}ssessment {B}attery for {C}hildren 2(nd) edition and the parent-reported {S}trengths and {D}ifficulties {Q}uestionnaire ({SDQ}). {M}ultiple linear regression models generated coefficients and 95% confidence intervals and potential mediating factors were tested. {P}revalence of {SHIP} was 13% at the 1(st) {ANV}, 9% at the 2(nd) {ANV}, and 1% at delivery. {SHIP} was not associated with low neurocognitive scores in children at six years. {H}igher {SDQ} internalizing scores, indicating increased emotional impairments in children, were associated with helminth infection at the 2(nd) {ANV}/delivery 1.07 (95% {CI} 0.15, 2.00) and at least once during pregnancy 0.79 (95% {CI} 0.12, 1.46) in adjusted models. {M}ediation analysis did not reveal significant indirect effects of several mediators on this association. {C}onclusions {O}ur study shows that while {SHIP} is not associated with impaired long-term neurocognitive development, infections may have significant negative impacts on emotional development in six-year-old children. {SHIP} remains a critical public health issue, and adequate prevention and treatment protocols should be enforced in low- and middle-income countries. {A}uthor summary {S}oil-transmitted helminth infections impact 1.5 billion individuals, primarily in low- and middle- income countries, each year and contribute to malnutrition, anemia, and impaired neurocognitive development in children. {H}owever, these infections in pregnancy and their impact on offspring have been less studied. {O}ne previous study found associations between soil-transmitted helminth infection during pregnancy and impaired cognitive functioning in offspring one year after birth. {T}he current study aimed to follow these children prospectively until six years in order to confirm whether these associations persisted or not. {I}nfections during pregnancy were no longer associated with cognitive or motor functioning in children; however, infections were associated with impaired behavioral development. {A}nimal-based models have hypothesized maternal inflammation and poor birth outcomes to be the mechanisms behind this relationship; however, our findings did not support these mechanisms. {T}his is one of very few prospective cohort studies in {S}ub-{S}aharan {A}frica to investigate these associations, and more research is needed to corroborate results. {L}imitations include limited power and the possibility that results are due to chance from multiple statistical tests. {A}dequate and accessible prevention and treatment efforts in pregnancy and childhood should be provided to populations in low- and middle- income countries at high risk of infection.},
  keywords = {{BENIN}},
  booktitle = {},
  journal = {{PL}o{S} {N}eglected {T}ropical {D}iseases},
  volume = {15},
  numero = {3},
  pages = {e0009260 [20 p.]},
  ISSN = {1935-2735},
  year = {2021},
  DOI = {10.1371/journal.pntd.0009260},
  URL = {https://www.documentation.ird.fr/hor/fdi:010081090},
}