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.
Bibliographical noteFunding Information:
We would like to thank Pete Bailey and Heather Kirby in the South Carolina Office of Research and Statistics for their work in preparing, cleaning and providing the data used in this study. We would also like to thank Dr. W. David Hager for his consultation regarding clinical and mechanistic aspects of the paper. This study was funded by Health Resources and Services Administration (HRSA) in the U.S. Department of Health and Human Services, HRSA Grant No. R40MC06636–01–00 “Maternal Sexual Infections and Adverse Child Outcomes”.
- Cohort Study
- Mental Retardation
- Trichomonas Vaginalis