From the Guidelines
Yes, Trichomonas vaginalis can be transmitted to a newborn baby during childbirth, although this is relatively uncommon. The primary transmission route is through direct contact with vaginal discharge as the baby passes through the birth canal.
Key Considerations
- If a pregnant woman has trichomoniasis, she should be treated with metronidazole, typically a single 2-gram oral dose or 500 mg twice daily for 7 days, as recommended by the Centers for Disease Control and Prevention 1.
- Treatment during pregnancy is important not only to prevent transmission to the baby but also because untreated trichomoniasis is associated with preterm birth and low birth weight, as noted in the guidelines for treating sexually transmitted diseases 1.
- Babies who do acquire the infection may develop vaginal discharge if female, or rarely urinary tract symptoms, and most infections in newborns are self-limiting and resolve within weeks, but treatment may be necessary in some cases.
- The parasite cannot survive long outside moist environments, so good hygiene practices after childbirth can help prevent transmission, and regular prenatal screening for sexually transmitted infections, including trichomoniasis, is an important preventive measure for expectant mothers.
Prevention and Treatment
- The recommended treatment for trichomoniasis in pregnant women is metronidazole, which has been shown to be effective in reducing the risk of transmission to the baby and preventing adverse pregnancy outcomes 1.
- It is essential to note that while metronidazole is the recommended treatment, there are limited data on the use of enhanced metronidazole regimens in pregnant women, and such cases should be managed in consultation with an expert in infectious diseases 1.
- Regular prenatal screening for sexually transmitted infections, including trichomoniasis, is crucial for preventing transmission to the baby and reducing the risk of adverse pregnancy outcomes, as emphasized in the guidelines for treating sexually transmitted diseases 1.
From the Research
Transmission of Trichomonas vaginalis to Newborns
- Trichomonas vaginalis can be vertically transmitted at birth, as stated in the study 2.
- The infection has been found in the pharynx and lower respiratory tract of neonates with respiratory disease, as reported in 2.
- A case study from 1977 found Trichomonas vaginalis in two newborn girls out of 948 admitted to a hospital, with both cases being linked to their mothers having vulvovaginitis trichomonalis 3.
- The study 3 also discussed the potential influence of maternal hormones on the infantile vagina, which may facilitate trichomoniasis in newborns.
Prevalence and Treatment
- Trichomoniasis is a common sexually transmitted infection that can cause vaginitis, cervicitis, and urethritis, as mentioned in 4 and 5.
- Metronidazole is a commonly used treatment for trichomoniasis, with a recommended dose of 2g oral single dose, even for asymptomatic patients, as stated in 2 and 6.
- However, metronidazole resistance is an emerging problem, and alternative treatments such as tinidazole may be necessary in cases of treatment failure, as discussed in 5.
Pregnancy and Trichomoniasis
- Trichomoniasis has been associated with adverse obstetric outcomes, including preterm delivery, low birth weight, and premature rupture of membranes, as reported in 2 and 6.
- The study 6 found that metronidazole treatment was effective in clearing the infection, but its impact on pregnancy outcomes is still unclear.