The relationship between resolution of asymptomatic bacterial vaginosis and spontaneous preterm birth in fetal fibronectin–positive women

Hendler, Israel; Andrews, William; Carey, Christopher; Klebanoff, Mark A.; Noble, William D.; Sibai, Bahaeddine M; Hillier, Sharon L.; Dudley, Donald J.; Ernest, Joseph M.; Leveno, Kenneth J.; Wapner, Ronald J.; Iams, Jay D.; Varner, Michael W.; Moawad, Atef H.; Miodovnik, Menachem; OʼSullivan, Mary J.; Dorsten, Peter J. Van

doi:10.1016/j.ajog.2007.03.073

Cited by 26 publications

(15 citation statements)

References 22 publications

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“…Ureaplasma urealyticum and Mycoplasma hominis have been isolated from the cord blood of approximately 23% of neonates born at less than 32 gestational weeks 34 . Most studies have reported an increased prevalence of preterm birth in women identified as having BV using Nugent criteria, with odds ratios (OR) between 2 and 6 35–37 . Approximately 10% to 15% of women with BV experience preterm birth 36 .…”

Section: Bacterial Vaginosis and Preterm Birthmentioning

confidence: 99%

“…If the natural course of BV during pregnancy is to resolve in most women, studies of antibiotic administration in early gestation may be treating women destined to resolve the condition spontaneously in later gestation. The population of women whose BV persists throughout pregnancy appears to have the worst outcomes, 35 regardless of whether or not they are treated with antibiotics. In addition, many studies reviewing antibiotic use in the context of increased risk factors for preterm birth have not differentiated between women with BV and women without.…”

Section: Screening and Treatment Of Bacterial Vaginosis In Pregnancymentioning

confidence: 99%

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Bacterial Vaginosis and Preterm Birth

Manns‐James¹

2011

J Midwife Womens Health

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Although it has been clear for more than 2 decades that bacterial vaginosis increases the risk for preterm birth in some women, it is not yet fully understood why this association exists or how best to modify the risk. Incomplete understanding of this polymicrobial condition and difficulties in classification contribute to the challenge. The relationship between altered vaginal microflora and preterm birth is likely mediated by host immune responses. Because treatment of bacterial vaginosis during pregnancy does not improve preterm birth rates, and may in fact increase them, screening and treatment of asymptomatic pregnant women is discouraged. Symptomatic women should be treated for symptom relief. This article reviews the pathophysiology of bacterial vaginosis and controversy surrounding management during pregnancy. Agents currently recommended for treatment of this condition are reviewed.

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Section: Bacterial Vaginosis and Preterm Birthmentioning

confidence: 99%

Section: Screening and Treatment Of Bacterial Vaginosis In Pregnancymentioning

confidence: 99%

Bacterial Vaginosis and Preterm Birth

Manns‐James¹

2011

J Midwife Womens Health

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“…Its diagnosis is based on either Amsel's criteria (taking into account vaginal pH, presence of discharge, amine odor, or presence of clue cells) or Nugent's score (a gram stain scoring system). Bacterial vaginosis is present in 15–42% of pregnant women and confers a 2 to 4-fold independent increase in the risk of spontaneous preterm birth and PROM [30–33]. In a meta-analysis including 18 studies, Leitich et al shows that the associated risk is greater when BV is diagnosed at earlier gestation [33].…”

Section: Introductionmentioning

confidence: 99%

Antimicrobials for Preterm Birth Prevention: An Overview

Subramaniam

Abramovici

Andrews

et al. 2012

Infectious Diseases in Obstetrics and Gynecology

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Objective. Preterm birth (PTB) remains a major cause of neonatal morbidity and mortality. The association between PTB and infection is clear. The purpose of this report is to present a focused review of information on the use of antibiotics to prevent PTB. Methods. We performed a search of the PubMed database restricted to clinical trials or meta-analyses published in English from 1990 through May 2011 using keywords “antibiotics or antimicrobials” and “preterm.” Results. The search yielded 67 abstracts for review. We selected 31 clinical trials (n = 26) or meta-analysis (n = 5) for further full-text review. Discussion of each eligible clinical trial, its specific inclusion criteria, antibiotic regimen used, and study results are presented. Overall, trials evaluating antibiotic treatment to prevent preterm birth have yielded mixed results regarding any benefit. Conclusion. Routine antibiotic prophylaxis is not recommended for prevention of preterm birth.

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“…failed to reduce the risk of preterm birth (P ¼ 0.84). Studies of bacterial vaginosis in pregnancy and preterm birth published since 2003 continue to emphasize an inconsistency of existing evidence(Table 3)[16,23,[61][62][63][64][65][66][67][68][69][70][71][72][73][74][75][76][77][78]. Two additional RCTs have been consequently published but failed to replicate the findings of the Cochrane review, though this may represent the use of different treatment approaches[61,62].…”

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confidence: 99%

Genitourinary pathogens and preterm birth

Cunnington

Kortsalioudaki

Heath

2013

Current Opinion in Infectious Diseases

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The potential for screening and treatment of genitourinary tract infections in pregnancy to reduce preterm birth rates has been demonstrated in some RCTs. Current guidelines do not reflect these data because of inconsistencies across the body of evidence. There is a need for robust RCTs to confirm or refute earlier data, to inform the optimal timing for screening in pregnancy and to better quantify the contribution of individual infections to the burden of preterm birth.

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The relationship between resolution of asymptomatic bacterial vaginosis and spontaneous preterm birth in fetal fibronectin–positive women

Cited by 26 publications

References 22 publications

Bacterial Vaginosis and Preterm Birth

Bacterial Vaginosis and Preterm Birth

Antimicrobials for Preterm Birth Prevention: An Overview

Genitourinary pathogens and preterm birth

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