Routine Use of an Antenatal Infection Screen‐and‐Treat Program to Prevent Preterm Birth: Long‐Term Experience at a Tertiary Referral Center

Farr, Alex; Kiss, Herbert; Hagmann, Michael; Marschalek, Julian; Husslein, Peter; Petricevic, Ljubomir

doi:10.1111/birt.12154

Cited by 37 publications

(54 citation statements)

References 18 publications

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“…5,6 In a study by Farr and Kiss, routine antenatal screening for Candida and Trichomonas vaginalis and treating them was found to be associated with significantly lower risk (nearly 2.5 times lower) of preterm birth. 7 Similar observation was made in an open label placebo controlled randomized trial, 6 where the authors found that treatment of asymptomatic Candida infection is associated with lower risk (OR 0.33) of preterm delivery.…”

Section: Discussionsupporting

confidence: 61%

Prevalence of abnormal Pap smear during pregnancy in a teaching hospital in South India

Mishra

Dorairajan

Siddaraju

et al. 2015

Int J Reprod Contracept Obstet Gynecol

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Section: Discussionsupporting

confidence: 61%

Prevalence of abnormal Pap smear during pregnancy in a teaching hospital in South India

Mishra

Dorairajan

Siddaraju

et al. 2015

Int J Reprod Contracept Obstet Gynecol

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“…For this reason, our department has integrated a program for all pregnant women, to screen and treat for the asymptomatic colonization with pathogens, including bacterial vaginosis and vaginal candidosis [11]. As it is known that recurrent vulvovaginal candidosis can be harmful during early pregnancy, the need for early detection and adequate antifungal treatment is clearly emphasized [10].…”

Section: Discussionmentioning

confidence: 99%

The colonization with Candida species is more harmful in the second trimester of pregnancy

Holzer

Farr

Kiss

et al. 2017

Arch Gynecol Obstet

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PurposeVaginal colonization with Candida species (spp.) during pregnancy has been associated with impaired pregnancy outcomes. There is a reduction in spontaneous preterm birth among women with recurrent asymptomatic colonization of Candida who were treated with clotrimazole. This study aimed to evaluate the impact of the trimester of vulvovaginal colonization with Candida species.MethodsData from all women, who were tested positive for the vaginal colonization with Candida spp. during the first or second trimester of pregnancy, and who registered for a planned birth at our tertiary referral center between 2005 and 2014 were retrospectively analyzed. Their preterm birth rate served as the primary outcome variable. Secondary outcome variables were neonatal birthweight and Apgar score.ResultsOverall, 1066 women were eligible for the study. In 673 women (63%), who were diagnosed with Candida spp. during the first trimester of pregnancy, the rate of preterm birth was 10% (N = 64). In 393 women (37%), who were diagnosed with candidosis during the second trimester, the preterm birth rate was 18% (N = 71; p = 0.0002). Neonates of women, who presented with vulvovaginal candidosis during the first trimester, had a mean birthweight of 3243 g, compared to 2989 g in the group with a second trimester colonization (p < 0.0001).ConclusionWomen who are colonized with Candida spp. during the second trimester of pregnancy have higher rates of preterm birth and lower neonatal birthweight than those who are colonized during the first trimester of their pregnancy. Screening programs for asymptomatic Candida colonization should take this information into account.

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“…A recently published Austrian study, implemented following the results of a randomized clinical trial, retrospectively analyzed the pregnancy outcome data of over 17,000 women at high risk of PTB (based on general, family, and obstetric risk factors) across a 10-year timespan following introduction of a voluntary antenatal infection “screen and treat” program (122). All women received standard antenatal care; 49.5% entered the screen and treat program, which consisted of testing of vaginal swabs at 10- to 16-week gestation for detection of BV and presence of Candida spp.…”

Section: Prevention Of Infection-driven Ptbmentioning

confidence: 99%

“…The effect of the program on the rates of early/extreme PTB was particularly impressive, with a more than 77% reduction observed; this is consistent with the known role of intrauterine infection in the majority of deliveries <32 weeks. The major weakness in this study is its retrospective, non-randomized design, although confounding is minimal and unlikely to alter the findings (122). …”

Section: Prevention Of Infection-driven Ptbmentioning

confidence: 99%

Applying Precision Public Health to Prevent Preterm Birth

Newnham

Kemp

White

et al. 2017

Front. Public Health

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Preterm birth (PTB) is one of the major health-care challenges of our time. Being born too early is associated with major risks to the child with potential for serious consequences in terms of life-long disability and health-care costs. Discovering how to prevent PTB needs to be one of our greatest priorities. Recent advances have provided hope that a percentage of cases known to be related to risk factors may be amenable to prevention; but the majority of cases remain of unknown cause, and there is little chance of prevention. Applying the principle of precision public health may offer opportunities previously unavailable. Presented in this article are ideas that may improve our abilities in the fields of studying the effects of migration and of populations in transition, public health programs, tobacco control, routine measurement of length of the cervix in mid-pregnancy by ultrasound imaging, prevention of non-medically indicated late PTB, identification of pregnant women for whom treatment of vaginal infection may be of benefit, and screening by genetics and other “omics.” Opening new research in these fields, and viewing these clinical problems through a prism of precision public health, may produce benefits that will affect the lives of large numbers of people.

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Routine Use of an Antenatal Infection Screen‐and‐Treat Program to Prevent Preterm Birth: Long‐Term Experience at a Tertiary Referral Center

Cited by 37 publications

References 18 publications

Prevalence of abnormal Pap smear during pregnancy in a teaching hospital in South India

Prevalence of abnormal Pap smear during pregnancy in a teaching hospital in South India

The colonization with Candida species is more harmful in the second trimester of pregnancy

Applying Precision Public Health to Prevent Preterm Birth

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