Signs of infection in Pap smears and risk of adverse pregnancy outcome.
Previous studies on whether signs of infection in Pap smears imply a risk factor for preterm delivery are conflicting. In a large population-based study, we combined information from the Swedish Medical Birth Register and the Swedish Pap Smear Screening Register to investigate whether signs of infection in Pap smears increase the risks of adverse pregnancy outcomes. Logistic regression analyses were used to estimate odds ratios (OR) for antepartum death, preterm or small-for-gestational-age delivery. The presence of Coccobacilli or Trichomonas vaginalis in Pap smears increased the risk of small-for-gestational-age delivery (OR 1.3 and 1.4, respectively). Signs of infection in Pap smears were generally not associated with an increased risk of antepartum death or preterm birth. However, the presence of Coccobacilli in Pap smears within 4 weeks before delivery was associated with a more than fourfold increase in risk of very preterm delivery (< or =31 weeks, OR 4.7). This indicates that if Coccobacilli are detected in Pap smears during the second trimester, antibacterial treatment may lower the risk of very preterm delivery.
Buchmayer
Susanne
S
Department of Medical Epidemiology, Karolinska Institutet, Stockholm, Sweden. buchmayer_@hotmail.com
Sparén
Pär
P
Cnattingius
Sven
S
D000293:Adolescent; D000328:Adult; D005260:Female; D005313:Fetal Death / Q000382:microbiology; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D008498:Medical Record Linkage; D007752:Obstetric Labor, Premature / Q000382:microbiology; D065006:Papanicolaou Test; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology*; D011256:Pregnancy Outcome; D012042:Registries; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology; D014247:Trichomonas Vaginitis / Q000150:complications / Q000453:epidemiology; D014626:Vaginal Smears; D014627:Vaginitis / Q000150:complications* / Q000453:epidemiology / Q000382:microbiology; D016585:Vaginosis, Bacterial / Q000150:complications / Q000453:epidemiology