Trichomoniasis in pregnancy and mental retardation in children.
OBJECTIVE
Trichomoniasis is a highly prevalent sexually transmitted infection and is associated with premature rupture of membranes, preterm birth, and low birth weight. This study examines the association between maternal trichomoniasis and intellectual disability (ID) in children.


METHODS
This study utilized linked maternal, infant, and child records for 134,596 Medicaid-insured singleton births in South Carolina from 1996 through 2002. Data were obtained from Medicaid billing records, birth certificates, and administrative data from the South Carolina Department of Education (DOE) and the Department of Disabilities and Special Needs (DDSN). Pregnancies during which women were diagnosed with urinary tract infection, chlamydia, gonorrhea, or vulvovaginal candidiasis were excluded, as were children diagnosed with a known cause of mental retardation. Odds of diagnosed ID in children were modeled using population averaged generalized estimating equation models.


RESULTS
Controlling for potential confounders, women with trichomoniasis were significantly more likely to have a child with ID (hazard ratio [HR] = 1.28; 95% confidence interval [CI], 1.12-1.46). The association was stronger for moderate to severe ID documented by the school system or DDSN (HR = 1.84; 95% CI, 1.35-2.51). Second-trimester trichomoniasis was associated with more than a three-fold increase in the odds a child was identified as trainable mentally handicapped or profoundly mentally handicapped in the public school system, or was receiving ID services from DDSN. There was not a significant difference in the risk of ID in children of women with treated versus untreated trichomoniasis.


CONCLUSIONS
Maternal trichomoniasis may be a preventable risk factor for ID.
Mann
Joshua R
JR
School of Medicine, University of South Carolina, Department of Family and Preventive Medicine, 3209 Colonial Dr., Columbia, SC 29203, USA. Joshua.mann@sc.edu
McDermott
Suzanne
S
Barnes
Timothy L
TL
Hardin
James
J
Bao
Haikun
H
Zhou
Li
L
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008607:Intellectual Disability / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D008795:Metronidazole / Q000009:adverse effects; D016017:Odds Ratio; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic / Q000453:epidemiology*; D011262:Pregnancy Trimester, Second; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology*; D016016:Proportional Hazards Models; D012307:Risk Factors; D013022:South Carolina; D014247:Trichomonas Vaginitis / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology*; D055815:Young Adult
D008795:Metronidazole