Is trichomoniasis associated with adverse preganancy outcome?

Abstract

Background: Trichomoniasis is the most common curable sexually transmitted disease worldwide, suspected of increasing the risk for adverse pregnancy outcomes. Objective: In this study, we aimed to determine influence of trichomoniasis on pregnancy outcome, detect the rate of trichomoniasis during pregnancy and to identify the risk factors of trichomoniasis. Patients and Methods: Vaginal swabs were obtained from 200 pregnant females with a gestational age of 13 to 40 weeks calculated according to the last menstrual cycle. Clinical examination, vaginal discharge wet mount, Giemsa stain, and culture in modified Diamond's media were performed. Metronidazole treatment was given for all positive cases. Patients were advised to encourage their partners to receive the same treatment. Sociodemographic information was collected, and cases were divided into two groups, the study group (infected) and the control group (not infected). Pregnancy outcome (full term delivery, preterm labor, premature membrane rupture, low birth weight infants) was assessed according to the elapsed time from the first sonogram to the week of delivery. Results: Twenty-four cases were positive for T. vaginalis. Positivity was mostly detected by culture (12%) followed by wet mount microscopy and/or Giemsa staining (8.5%). Premature rupture of membrane was detected in 17/24 (70%) of trichomoniasis positive and in 29/176 (16.5%) of trichomoniasis negative cases (P=0.0001). Preterm delivery was detected in 12/24 (50%) of positive cases and 29/176 (16.5%) of negative cases (P=0.0001). Low birth weight of infants was observed in 17/24 (70%) of positive cases and in 28/176 (15.9%) of negative cases (P=0.0001). Premature membrane rupture and preterm delivery were statistically significant in positive cases with bad compliance to metronidazole treatment (P=0.044) and (P=0.004), respectively. The high rate of infection was observed in age group of 26-35 years (P=0.017). In addition, isolation of the parasite was significantly (P>0.05) recorded in pregnant women presenting with vaginal discharge and history of previous infection. Conclusion:Our results highlight the presence of preterm delivery and delivery of low birth weight infants in infected pregnant women presenting with vaginal discharge and a history of previous infection. Premature membrane rupture and preterm delivery were statistically significant in positive cases with bad compliance to metronidazole treatment. Therefore, pregnant women should be screened for trichomoniasis to reduce the incidence of preterm delivery and low birth weight.