Approximately 44 million pregnancies occur globally each year in women infected by helminths (http://www.ncbi.nlm.nih.gov/pubmed/19370621) and there is no indication that either human hookworm or human whipworm can harm a developing foetus.
Studies have found that, where good, general antenatal care is provided, the de-worming of pregnant women produces no benefits in respect of anaemia, birth weight, perinatal mortality, infant mortality or infant response to immunisation.
However, if a woman were to fall pregnant while hosting therapeutic helminths and wished to terminate the infection, it is not recommended that she do this by taking mebendazole tablets. A few lungfuls of nitrous oxide would arguably be better, inhaled from a whipped cream or other pressurised food dispenser.
Current epidemiological findings suggest that pre-natal exposure to helminth infection may have an important effect on the development of the foetal immune response and that this might help prevent the development of inflammatory conditions such as allergy.
There is also evidence from a study in mice that helminth infection during pregnancy may reduce the susceptibility of the offspring to allergic airway inflammation.
Sepsis, a condition that is hard to recognise and treat, is an increasing cause of complications and death among women in the West, and rates of severe and fatal sepsis during labor and delivery are rising sharply, such that sepsis is now the leading cause of direct maternal death in the UK.
As a helminth infection counterbalances the exacerbated pro-inflammatory immune responses that occur during sepsis, thus improving survival, it is arguable that the presence of a small colony of therapeutic helminths might actually prevent a woman developing sepsis.
Hosting helminths may also help women with ulcerative colitis stay healthy during pregnancy.
One woman who examined all the available evidence on the risks and benefits of hosting helminths during pregnancy came to the following conclusion.
“I got hookworm (and a just a couple whipworms) actually to help keep my immune system in check during my next pregnancy, since my first kid is on the autism spectrum. Went to the high risk ObGyn and they said I am in excellent shape. My iron, ferritin, hemoglobin, etc. are all normal. From my research it seems safe in low doses and can prevent allergy in offspring, another reason I decided to go for this. Not pregnant yet, just planning.”
Someone else, who had previously had two children with severe eosinophilic esophagitis-related food intolerances, maintained a hookworm colony throughout her next pregnancy and delivered a healthy, allergy-free baby.
Notwithstanding the potential benefits of establishing a helminth colony before becoming pregnant, the possible risks of commencing helminthic therapy for the first time DURING pregnancy are unknown. Therefore, if a woman wishes to initiate treatment during her pregnancy, it would be advisable to do this under the supervision of a physician.
If a woman were to start therapy while pregnant, without medical supervision, and were to have a miscarriage, or encounter a problem with the new born baby, she might blame the helminths and seek to take action against whoever supplied them. Therefore, providers of therapeutic helminths must act with caution, and they will usually recommend waiting until after the pregnancy before starting therapy.
Helminthic therapy in pregnancy was discussed at length in the 13 messages in this thread (‘Pregnancy and hookworms’) in Sept 2010
and in 10 messages in this thread (‘Thinking of inoculating while pregnant’) in Aug/Sept 2011.
The topic was also discussed in the Facebook HT Support group in Sept 2013.
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Last updated on 3 Aug 2014.