This research is responsive to MCHB Strategic Research Issue #IV - promoting the healthy development of MCH populations. The overall goal of this project is to answer the research question: Do sexually associated infections during pregnancy result in an increased risk for fetal death, mental retardation (MR) and developmental delay (DD)? In order to answer the research question, we will analyze data from a cohort of over 152,000 Medicaid maternal-child pairs in a retrospective cohort design. The study will examine maternal sexually associated illnesses, diagnostic procedures, and treatments used during the prenatal period, and their association with infant and childhood morbidity and mortality. Sexually associated diseases will include sexually transmitted diseases, infections associated with intercourse (including UTI during pregnancy) and some possibly associated with sexual activity (bacteria vaginosis and candidiasis). A major strength of this study is the large sample size available for analysis. Another notable strength is the ability to link mother and child files that incorporate medical diagnoses and prescription information as well as early childhood data. We have the capability to exclude children with known causes of MR/DD since we have diagnosis and treatment codes. By excluding these children, we will be able to focus on the role of sexuality associated diseases in otherwise unexplained cases of MR/DD; further, we will avoid the dilution of measurable effects that would likely occur if known causes were kept in the analysis. Our use of prospectively collected data alleviates the potential problem of bias in reporting sexually associated infections in relation to childhood outcomes. The benefit of this research is to provide information about the impact of treated and untreated sexually associated conditions on fetal and infant outcomes. There is potential for prevention if treated sexually associated conditions are not associated with adverse outcomes and untreated conditions are associated with adverse outcomes. Medicaid program recipients (including minority children, children with special health care needs and children of low socioeconomic status) will directly benefit from this project since the findings can be used to inform prevention and treatment.
Listed is descending order by year published.
Mann JR, McDermott S, Bao H, Bersabe A. Maternal genitourinary infection and risk of cerebral palsy. Dev Med Child Neurol. 2009 Apr;51(4):282-8.
Mann JR, McDermott S, Barnes TL, Hardin J, Bao H, Zhou L. Trichomoniasis in pregnancy and mental retardation in children. Ann Epidemiol. 2009 Dec;19(12):891-9.
Mann JR, McDermott S, Gregg A, Gill TJ. Maternal genitourinary infection and small for gestational age. Am J Perinatol. 2009 Oct;26(9):667-72.
Mann JR, McDermott S, Zhou L, Barnes TL, Hardin J. Treatment of trichomoniasis in pregnancy and preterm birth: an observational study. J Womens Health (Larchmt). 2009 Apr;18(4):493-7.