Treatment of bacterial vaginosis in pregnancy in order to reduce the risk of spontaneous preterm delivery – a clinical recommendation

Abstract

This systematic review gives a strong recommendation against treatment with metronidazole and a weak recommendation against treatment with clindamycin to reduce the sPTD rate in both high-risk and low-risk pregnancies with BV.

Sulfadoxine-Pyrimethamine Exhibits Dose-Response Protection Against Adverse Birth Outcomes Related to Malaria and Sexually Transmitted and Reproductive Tract Infections

“…Metronidazole treatment among women in low-risk pregnancies appeared to increase preterm births (risk ratio, 1.11; 95% CI, 0.93, 1.34) and offered no effect in high-risk pregnancies (risk ratio, 0.96; 95% CI, 0.78, 1.18). In contrast, clindamycin reduced the risk of preterm birth by 13% (risk ratio, 0.87; 95% CI, 0.73–1.05) [37], is safe in pregnancy, is well tolerated, and has been used as monotherapy for the treatment of uncomplicated Plasmodium falciparum infection [38]. There is a need to conduct longitudinal studies to investigate the potential protective effect of treatments that involve dihydroartemisinin–piperaquine plus azithromycin and/or clindamycin that also involve the use of postpartum anthropometry to measure reductions in infant stunting [39].…”

The treatment of bacterial vaginosis in pregnancy with clindamycin to reduce the risk of infection‐related preterm birth: a response to the Danish Society of Obstetrics and Gynecology guideline group's clinical recommendations

“…In contrast, the recent Danish clinical recommendations (produced by a guideline group within the DSOG) on the treatment of BV in pregnancy recommended against the use of clindamycin to reduce the risk of PTB . After careful analysis, we believe that this recommendation was reached erroneously on the basis of two flawed decisions relating to study inclusion criteria, and as a result, the recommendation provides incorrect advice to the obstetric community on the effectiveness of clindamycin for this indication.…”

Treatment of Bacterial Vaginosis in Early Pregnancy and its Effect on Spontaneous Preterm Delivery and Preterm Premature Rupture of Membranes

“…In the latest review by Haahr el al. [18] just published they still look at spontaneous preterm delivery before 37th week and the worst error is that they add a study by Subtil that are unpublished and are only available only as an abstract. This study will interfere with the result and make the conclusion of the review not to recommend treatment of BV.…”