HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by FRENCH, J. I. Articles by MCFEE, J. Search for Related Content PubMed PubMed Citation Articles by FRENCH, J. I. Articles by MCFEE, J.

Gestational Bleeding, Bacterial Vaginosis, and Common Reproductive Tract Infections: Risk for Preterm Birth and Benefit of Treatment

From the Department of Obstetrics and Gynecology at Denver Health Medical Center, and the University of Colorado Health Sciences Center, Denver, Colorado.

Address reprint requests to: Janice I. French, CNM, MS Department of Obstetrics and Gynecology Denver Health Medical Center, Code 0660 777 Bannock Street Denver, CO 80204 E-mail: jan.french{at}dhha.org

Objective: To examine associations between bacterial vaginosis and other prevalent lower genital tract infections and clinically recognized first-trimester bleeding; possible independent and joint effects of gestational bleeding and bacterial vaginosis or other prevalent infections on preterm birth and premature rupture of membranes; and effects of antimicrobial treatment on reducing risks of preterm birth among these women.

Methods: A secondary analysis was conducted of 1100 pregnant women enrolled in a prospective observational study that examined the effects of standardized diagnosis and treatment of lower genital tract infections to prevent preterm birth.

Results: Sixty percent of women with first-trimester bleeding had one or more study infections detected at the initial examination. First-trimester bleeding was associated independently with the presence of bacterial vaginosis (odds ratio [OR] 1.5, 95% confidence interval [CI] 1.0, 2.3), Trichomonas vaginalis (OR 2.3, 95% CI 1.3, 4.2), and Chlamydia trachomatis (OR 2.7, 95% CI 1.4, 5.1). Preterm birth was increased among women with first-trimester bleeding and bacterial vaginosis (relative risk [RR] 4.4, 95% CI 2.0, 9.5) and bacterial vaginosis and T vaginalis (RR 3.0, 95% CI 1.0, 8.8). Systemic antimicrobial treatment reduced the rate of preterm birth among women with bacterial vaginosis without first-trimester bleeding (RR 0.37, 95% CI 0.16, 0.88). Treatment of women with both first-trimester bleeding and bacterial vaginosis reduced preterm birth (RR 0.52, 95% CI 0.18, 1.55), but not significantly.

Conclusion: First-trimester bleeding was increased among women with bacterial vaginosis, T vaginalis, C trachomatis, and combinations of these infections. Women with bacterial vaginosis who also experienced first-trimester bleeding were at heightened risk for preterm birth. Treatment of studied infections reduced significantly the risks of preterm birth among women without first-trimester bleeding.

This article has been cited by other articles:

				N. Okun, K. A. Gronau, and M. E. Hannah Antibiotics for Bacterial Vaginosis or Trichomonas vaginalis in Pregnancy: A Systematic Review Obstet. Gynecol., April 1, 2005; 105(4): 857 - 868. [Abstract] [Full Text] [PDF]

				J. Yang, K. E. Hartmann, D. A. Savitz, A. H. Herring, N. Dole, A. F. Olshan, and J. M. Thorp Jr. Vaginal Bleeding during Pregnancy and Preterm Birth Am. J. Epidemiol., July 15, 2004; 160(2): 118 - 125. [Abstract] [Full Text] [PDF]

				T. Stelmach, E. Kallas, H. Pisarev, and T. Talvik Antenatal Risk Factors Associated With Unfavorable Neurologic Status in Newborns and at 2 Years of Age J Child Neurol, February 1, 2004; 19(2): 116 - 122. [Abstract] [PDF]