Antibiotic treatment of bacterial vaginosis in pregnancy: A meta-analysis

General obstetrics: A randomised controlled trial of metronidazole for the prevention of preterm birth in women positive for cervicovaginal fetal fibronectin: the PREMET Study

“…A recent meta-analysis of antibiotic treatment of BV in women at high risk of preterm delivery confirmed the statistical heterogeneity of the results from randomised controlled trials. 25 However, subanalysis suggested that prolonged treatment of more than a week maybe beneficial, although clindamycin was the most common antimicrobial used in these studies.…”

Changes in the Vaginal Microenvironment with Metronidazole Treatment for Bacterial Vaginosis in Early Pregnancy

“…1 BV has been associated with preterm delivery 2 even after correction for demographic and obstetrical risk factors, although treatment for BV in pregnancy does not consistently reduce the risk of preterm delivery. [3][4][5] Some hypothesize that preterm delivery may not be related to BV per se but rather to an inflammatory immune response, which may not diminish with treatment for infection. 6 Studies among women in preterm labor have consistently demonstrated associations between BV and positive amniotic fluid cultures, increased levels of proinflammatory amniotic fluid cytokines, and histological chorioamnionitis.…”

Prepregnancy counseling: preterm birth

“…There is no evidence in this meta-analysis that treatment of all asymptomatic pregnant women with BV reduced the incidence of preterm birth; there could be some benefit for women with a history of preterm birth [102]. A recent meta-analysis from Leitich et al [103] demonstrated the effectiveness for screening for BV in women at high risk for preterm delivery. In women with BV and a previous preterm birth treatment of BV with metromidazole [104,105] or metromidazole plus erythromycin [106] reduces the risk of recurrent preterm delivery.…”