What is the risk for preterm birth after treatment of trichomoniasis?

Updated: Jan 02, 2020
  • Author: Darvin Scott Smith, MD, MSc, DTM&H; Chief Editor: Michael Stuart Bronze, MD  more...
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The National Institute of Child Health and Human Development Maternal Fetal Medicine Units Network presented data suggesting that metronidazole treatment of asymptomatic carriers of T vaginalis increased the risk of preterm birth. [124, 125] This was a controversial conclusion in that the investigators treated T vaginalis infection with 4 doses of 2 g metronidazole, which is significantly more than what is standard practice. The women included in the study were between 16 and 23 weeks’ gestational age, suggesting a significant delay in treatment. A subsequent study by Mann et al showed no increased risk of preterm birth with the use of metronidazole for the treatment of trichomoniasis. [126]

Although the CDC does not take a definitive stance on treating trichomoniasis during pregnancy, it recommends a single 2–g dose of metronidazole if treatment is deemed necessary. [11] Treatment of trichomoniasis during pregnancy may relieve symptoms of vaginal discharge or prevent the rare complication of neonatal respiratory infection with trichomoniasis. Treatment has not been shown to reduce the incidence of preterm-delivery associated with T vaginalis infection. [11] Vertical transmission of trichomoniasis during delivery is relatively rare, but respiratory or genital infection of the newborn during delivery has been reported. [8] Infected asymptomatic pregnant women may wish to defer treatment until after 37 weeks’ gestation. [48]

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