Kigozi Godfrey G, Brahmbhatt Heena, Wabwire-Mangen Fred, Wawer Maria J, Serwadda David, Sewankambo Nelson, Gray Ronald H
Rakai Project, Uganda Virus Research Institute, Entebbe and Kampala, Uganda.
Am J Obstet Gynecol. 2003 Nov;189(5):1398-400. doi: 10.1067/s0002-9378(03)00777-4.
The purpose of this study was to assess the association of presumptive Trichomonas vaginalis treatment during pregnancy and birth outcomes.
A community-randomized trial of presumptive sexually transmitted disease treatment during pregnancy was conducted between 1994 and 1999 in Rakai district, Uganda. A subanalysis of a trial of presumptive therapy with azithromycin, cefixime, and metronidazole assessed Trichomonas vaginalis treatment in pregnant women.
Children of 94 women with Trichomonas who were treated had increased low birth weight (relative risk, 2.49; 95% CI, 1.12-5.50), preterm birth rate (relative risk, 1.28; 95% CI, 0.81-2.02), and 2-year mortality rate (relative risk, 1.58; 95% CI, 0.99-2.52), compared with children of 112 women with Trichomonas who were not treated.
Treatment of Trichomonas vaginalis during pregnancy may be deleterious, and we infer that this may be due to metronidazole. This is consistent with a National Institute for Child Health and Human Development trial that found an excess of preterm births in children of women with Trichomonas vaginalis infection who were treated with metronidazole.
本研究旨在评估孕期对疑似阴道毛滴虫感染进行治疗与分娩结局之间的关联。
1994年至1999年期间，在乌干达的拉凯区开展了一项关于孕期对疑似性传播疾病进行治疗的社区随机试验。对一项使用阿奇霉素、头孢克肟和甲硝唑进行推定治疗的试验进行了亚分析，以评估孕妇的阴道毛滴虫治疗情况。
与112名未接受治疗的阴道毛滴虫感染女性所生子女相比，94名接受治疗的阴道毛滴虫感染女性所生子女的低体重出生风险增加（相对风险为2.49；95%置信区间为1.12 - 5.50）、早产率增加（相对风险为1.28；95%置信区间为0.81 - 2.02）以及2岁死亡率增加（相对风险为1.58；95%置信区间为0.99 - 2.52）。
孕期治疗阴道毛滴虫感染可能有害，我们推断这可能是由于甲硝唑所致。这与美国国立儿童健康与人类发展研究所的一项试验结果一致，该试验发现，接受甲硝唑治疗的阴道毛滴虫感染女性所生子女中早产情况增多。
