Antibiotics for treating bacterial vaginosis in pregnancy

Abstract

Background-Bacterial vaginosis is an imbalance of the normal vaginal flora with an overgrowth of anaerobic bacteria and a lack of the normal lactobacillary flora. Bacterial vaginosis during pregnancy has been associated with poor perinatal outcome and, in particular, preterm birth (PTB). Identification and treatment may reduce the risk of PTB and its consequences. Objectives-To assess the effects of antibiotic treatment of bacterial vaginosis in pregnancy. Search methods-We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (May 2006). We updated this search on 18 November 2010 and added the results to the awaiting classification section. Selection criteria-Randomized trials comparing antibiotic treatment with placebo or no treatment, or comparing two or more antibiotic regimens in pregnant women with bacterial vaginosis or intermediate vaginal flora. Data collection and analysis-Two review authors assessed trials and extracted data independently. We contacted study authors for additional information. Main results-We included fifteen trials of good quality, involving 5888 women. Antibiotic therapy was effective at eradicating bacterial vaginosis during pregnancy (Peto odds ratio (OR) 0.17, 95% confidence interval (CI) 0.15 to 0.20; 10 trials, 4357 women). Treatment did not reduce the risk of PTB before 37 weeks (Peto OR 0.91, 95% CI 0.78 to 1.06; 15 trials, 5888 women), or the risk of preterm prelabour rupture of membranes (PPROM)

Reduction in Preterm Delivery and Neonatal Mortality after the Introduction of Antenatal Cotrimoxazole Prophylaxis among HIV‐Infected Women with Low CD4 Cell Counts

“…Antibiotic prophylaxis has been extensively investigated as a strategy to reduce preterm delivery among HIV-uninfected women in the United States and elsewhere, but the benefits are not clear-cut [12]. Most reviews suggest that there is little benefit for general populations [12] but that there may be some benefit in certain high-risk groups, such as women with bacteriuria [34] or women with bacterial vaginosis and a history of preterm birth [35]. There are important differences between our study and many of these prior studies.…”

Bacterial Vaginosis in Lesbians and Bisexual Women

“…15 Lesbians may choose to become pregnant 9 ; routine screening for BV in low-risk asymptomatic pregnant women does not lead to improved maternal or fetal outcomes, although antibiotic treatment of BV in women at high risk of premature delivery is recommended. 16 …”

Estimated global resources needed to attain universal coverage of maternal and newborn health services

“…Incidence of tetanus infection among neonates 22 Antibiotics for pre-labour rupture of membranes Delay in delivery and reduction in neonatal morbidity including infections 23 Treatment of bacterial vaginosis Incidence of pre-labour rupture of membranes and low birth weight 24 Active management of third stage of labour Incidence of postpartum haemorrhage 25 External cephalic version Need for caesarean section 26…”