Abstract:
Objectives—To determine whether treatment of trichomoniasis increases the risk of prematurity.
Design—Sub-analysis of a randomised trial.Setting—We analysed data from HPTN 024, a randomised trial of antenatal and intrapartum
antibiotics to reduce chorioamnionitis-related perinatal HIV transmission.
Subjects—Pregnant women from four sites in Africa.
Outcome measures—Gestational age at the time of delivery or mean birth weight.
Results—Of 2 428 women-infant pairs included, 428 (18%) had trichomoniasis at enrolment.
There were no differences in infant age or birth weight between women with or without
trichomoniasis. By randomisation group, there were no differences in gestational age at birth or
birth weight. Of the 428 women diagnosed with trichomoniasis, 365 (83%) received antibiotics
and 63 (15%) did not. In analysis of actual use of antibiotics, women with trichomoniasis who
received no treatment were more likely to deliver a preterm infant when the symphysis-fundal
height was used to estimate gestational age (36% v. 23%; p=0.03), but not when the Ballard score
was used (16% v. 21%; p=0.41). There were no differences in mean birth weight between groups.
Conclusions—In pregnant women in sub-Saharan Africa, most of whom were HIV-infected,
neither trichomoniasis nor its treatment appears to influence the risk of preterm birth or a lowbirth-
weight infant.
