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BACTERIAL VAGINOSIS AND PRETERM DELIVERY.

Previous research has suggested an association between bacterial vaginosis and preterm delivery. In a new multicenter American study, researchers followed over 10,000 pregnant women, of whom 16 percent had bacterial vaginosis at 23 to 26 weeks' gestation.

Preterm delivery of a low-birth-weight infant was significantly more likely in women with bacterial vaginosis than in those without it (6.3 vs. 4.2 percent). In a multivariate analysis, bacterial vaginosis was independently associated with preterm low-birth-weight delivery, as were smoking, black race, previous low-birth-weight delivery, loss of an earlier pregnancy, and primigravidity. Infection with vaginal bacteroides and Mycoplasma hominis, but not gardnerella, was independently associated with preterm delivery of a low-birth-weight child.

A second study randomized 624 women at high risk for premature delivery to receive either placebo or one week of metronidazole plus two weeks of erythromycin, at about 23 weeks' gestation. Among a subgroup of 258 women with bacterial vaginosis, the antibiotic-treated group had a significantly lower rate of premature delivery than the placebo group (31 vs. 49 percent). Antibiotics did not lower the rate of premature delivery among women without bacterial vaginosis.

Comment: These two studies, taken together, strengthen the case for a cause-and-effect relationship between bacterial vaginosis and preterm delivery. However, it is possible that bacterial vaginosis is a marker for other upper genital tract infections that promote premature delivery and are susceptible to antibiotics.

— AS Brett

Published in Journal Watch General Medicine January 5, 1996

Citation(s):

Hillier SL et al. Association between bacterial vaginosis and preterm delivery of a low-birth-weight infant. N Engl J Med 1995 Dec 28 333 1737-1742.

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• Medline abstract (Free)

Hauth JC et al. Reduced incidence of preterm delivery with metronidazole and erythromycin in women with bacterial vaginosis. N Engl J Med 1995 Dec 28 333 1732-1736.

• Original article (Subscription may be required)
• Medline abstract (Free)