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Background: Several studies have suggested that pregnant women infected with Trichomonas vaginalis may be at increased risk of an adverse outcome. Goal: To evaluate prospectively the association between T. vaginalis and risk of adverse pregnancy outcome in a large cohort of ethnically diverse women. Study Design: At University-affiliated hospitals and antepartum clinics in five United States cities, 13,816 women (5,241 black, 4,226 Hispanic, and 4,349 white women) were enrolled at mid-gestation, tested for T vaginalis by culture, and followed up until delivery. Results: The prevalence of T vaginalis infection at enrollment 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 T vaginalis at mid-gestation was significantly associated with low birth weight (odds ratio 1.3; 95% confidence interval 1.1 to 1.5), preterm delivery (odds ratio 1.3; 95% confidence interval 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 at tributable risk of T vaginalis infection associated with low birth weight in blacks was 11% compared with 1.6% in Hispanics and 1.5% in whites. Conclusions: After considering other recognized risk factors including co-infections, pregnant women infected with T. vaginalis at mid-gestation were statistically significantly more likely to have a low birth weight infant, to deliver preterm, and to have a preterm low birth weight infant. Compared with whites and Hispanics, T vaginalis infection accounts for a disproportionately larger share of the low birth weight rate in blacks., Pregnant women infected with Trichomonas vaginalis appear to be at increased risk for delivery complications. T. vaginalis infection and delivery complication rates were determined among 13,816 pregnant women. Overall, 12.6% of the women were infected with T. vaginalis mid-way through pregnancy. Infected women were 1.3 times more likely to deliver prematurely or to have a low birth weight infant. They were 1.4 times more likely to deliver a low-birth-weight infant prematurely. The highest infection rates were seen among black women who also had a higher risk of low-birth-weight infants than other ethnic groups.

Administering erythromycin to pregnant women with vaginal infections may not be successful in preventing preterm delivery or low birth weight in infants. Researchers studied 938 pregnant women with group B streptococci vaginal infections to see if erythromycin given in the third trimester would resolve the infection and prevent preterm delivery. Preterm deliveries and the number of low birthweight infants were not reduced significantly. The effects of erythromycin in the study may not have been dramatic because only 385 of the women were very infected. Erythromycin administered earlier in pregnancy may be more effective in preventing pregnancy problems.

Genital infections during pregnancy have been associated with prematurity and low birth weight. However, the association between infections with organisms such as Ureaplasma urealyticum and poor pregnancy outcome has not been consistent. In some studies, antibiotic treatment of women infected with U. urealyticum or other bacteria resulted in fewer premature infants, while other studies suggested that prematurity and U. urealyticum infection are not associated. As part of a large study, the effects of the antibiotic erythromycin or placebo on the pregnancy outcomes of 1,181 women were evaluated. This study differed from others in that women with infections in addition to U. urealyticum were excluded. The subjects received treatment beginning between 26 and 30 weeks gestation to term, three times daily. Erythromycin treatment did not eliminate the organism from subjects' lower genital tracts, and no effect on pregnancy outcome was found. (Consumer Summary produced by Reliance Medical Information, Inc.)

Prematurity and low birth weight are the major causes of newborn illness and death in the US. Genital infections have been implicated as a cause of prematurity and low birth weight, but the association between infections with organisms such as Ureaplasma urealyticum and poor pregnancy outcome has not been consistent. A large study involving several hospitals was conducted to determine whether genital infections and pregnancy outcome were related. In this report, 4,934 women were evaluated for vaginal infections with U. urealyticum between 23 and 26 weeks of gestation. The organism was present in 66 percent of the women studied, and was the most common organism found. The organism was more commonly found in black women, in those carrying their first child, and in unmarried women, and significantly decreased with increasing age, income, and education. The presence of the organism was also significantly related to smoking and to a more frequent number of sexual partners. U. urealyticum was somewhat associated with delivery of a low-birth weight infant, but this was not independent of other factors such as ethnicity, smoking, past number of children delivered, and presence of another organism. It is concluded that genital infection with U. urealyticum is not significantly associated with a poor pregnancy outcome. Therefore, tests for this infection in pregnant women to predict those at high risk are not justified. (Consumer Summary produced by Reliance Medical Information, Inc.)