Trichomoniasis in Pregnancy and Mental Retardation in Children

Purpose

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.

Conclusion

Maternal trichomoniasis may be a preventable risk factor for ID.

Key Words: Mental Retardation, Trichomonas Vaginalis, Pregnancy, Cohort Study

Selected Abbreviations and Acronyms: ID, intellectual disability, UTI, urinary tract infection, DOE, Department of Education, DDSN, Department of Disabilities and Special Needs, ICD, International Classification of Diseases, MR, mental retardation, EMH, Educable Mentally Handicapped, TMH, Trainable Mentally Handicapped, PMH, Profoundly Mentally Handicapped, IQ, intelligence quotient