Don't ignore asymptomatic trichomoniasis: higher GM-CSF concentrations seen with such infections in pregnancy and indicate inflammatory response.(Obstetrics)

CHARLESTON, S.C. -- Asymptomatic trichomoniasis during pregnancy appears to elicit a maternal inflammatory response, and should not be ignored, Brenna L. Anderson, M.D., said during the annual meeting of the Infectious Diseases Society for Obstetrics and Gynecology.

In a nested case-control study of 199 serum samples from women enrolled in the Vaginal Infections and Prematurity Study between 23 and 26 weeks' gestation and followed until delivery, median concentrations of granulocyte-macrophage colony-stimulating factor (GM-CSF) were significantly higher in samples from women with asymptomatic trichomoniasis than in those without the infection, indicating a systemic inflammatory response.

Also, those with trichomoniasis were significantly more likely to have a GM-CSF concentration in the highest quartile.

The association between infection and GM-CSF concentrations persisted even after the investigators controlled for center, tobacco use, and bacterial vaginosis, said Dr. Anderson of the University of Pittsburgh.

She noted that both the case and control samples were matched for race and sexually transmitted disease coinfection.

The two groups did not differ in regard to maternal age, gestational age at delivery, and rate of chlamydia or gonorrhea, she reported.

The inflammatory response appears to be exacerbated by coinfection with other sexually transmitted infections. There was a significant test for trend in those coinfected with gonorrhea or chlamydia, compared with those infected with only trichomoniasis and those with no sexually transmitted infection, she said.