Bacterial vaginosis in pregnancy and the risk of prematurity: a meta-analysis.
OBJECTIVE
We conducted this meta-analysis to determine the magnitude of risk conferred by bacterial vaginosis during pregnancy on preterm delivery.


METHODS
We selected articles from a combination of the results of a MEDLINE search (1966-1996), a manual search of bibliographies, and contact with leading researchers.


METHODS
We included case control and cohort studies evaluating the risk of preterm delivery, low birth weight, preterm premature rupture of membranes, or preterm labor for pregnant women who had bacterial vaginosis and those who did not. DATA COLLECTION AND ANALYSIS. Two investigators independently conducted literature searches, applied inclusion criteria, performed data extraction, and critically appraised included studies. Summary estimates of risk were calculated as odds ratios (ORs) using the fixed and random effects models.


RESULTS
We included 19 studies in the final analysis. Bacterial vaginosis during pregnancy was associated with a statistically significant increased risk for all outcomes evaluated. In the subanalyses for preterm delivery, bacterial vaginosis remained a significant risk factor. Pooling adjusted ORs yielded a 60% increased risk of preterm delivery given the presence of bacterial vaginosis.


CONCLUSIONS
Bacterial vaginosis is an important risk factor for prematurity and pregnancy morbidity. Further studies will help clarify the benefits of treating bacterial vaginosis and the potential role of screening during pregnancy.
Flynn
C A
CA
Center for Evidence Based Practice, Department of Medicine, State University of New York, Health Science Center at Syracuse, USA. flynnc@mailbox.hscsyr.edu
Helwig
A L
AL
Meurer
L N
LN
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D015201:Meta-Analysis as Topic; D007752:Obstetric Labor, Premature / Q000382:microbiology*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy; D012307:Risk Factors; D016585:Vaginosis, Bacterial / Q000150:complications* / Q000188:drug therapy
D000900:Anti-Bacterial Agents