TRICHOMONAS-VAGINALIS ASSOCIATED WITH LOW-BIRTH-WEIGHT AND PRETERM DELIVERY

Background: Several studies have suggested that pregnant women infecte d with Trichomonas vaginalis may be at increased risk of an adverse ou tcome. Goal: To evaluate prospectively the association between T. vagi nalis and risk of adverse pregnancy outcome in a large cohort of ethni cally diverse women. Study Design: At University-affiliated hospitals and antepartum clinics in five United States cities, 13,816 women (5,2 41 black, 4,226 Hispanic, and 4,349 white women) were enrolled at mid- gestation, tested for T. vaginalis by culture, and followed up until d elivery. Results: The prevalence of T. vaginalis infection at enrollme nt was 12.6%. Race-specific prevalence rates were 22.8% for black, 6.6 % for Hispanic, and 6.1% for white women. After multivariate analysis, vaginal infection with I: vaginalis at mid-gestation was significantl y associated with low birth weight (odds ratio 1.3; 95% confidence int erval 1.1 to 1.5), preterm delivery (odds ratio 1.3; 95% confidence in terval 1.1 to 1.4), and preterm delivery of a low birth weight infant (odds ratio 1.4; 95% confidence interval 1.1 to 1.6). The attributable risk of T. vaginalis infection associated with low birth weight in bl acks was 11% compared with 1.6% in Hispanics and 1.5% in whites. Concl usions: After considering other recognized risk factors including co-i nfections, pregnant women infected with T. vaginalis at mid-gestation were statistically significantly more likely to have a low birth weigh t infant, to deliver preterm, and to have a preterm low birth weight i nfant. Compared with whites and Hispanics, T. vaginalis infection acco unts for a disproportionately larger share of the low birth weight rat e in blacks.