The effect of treating bacterial vaginosis on preterm labor.
OBJECTIVE
Multiple studies suggest that bacterial vaginosis (BV) causes preterm labor; yet its routine treatment remains controversial. In order to help to elucidate this controversy, we performed a thorough review of studies with levels of evidence ranging from I to II-II.


METHODS
We searched for all of the studies from the years 1994 to 2001 via Medline's database, including MD Consult and Ovid Mednet.


RESULTS
Several trials discovered a decrease in the incidence of preterm labor when BV was treated, but most of those trials were performed on women with a history of preterm labor. However, the majority of trials reviewed advise against treatment of a general low-risk obstetric population, as there was no significant decrease in preterm labor.


CONCLUSIONS
Therefore, based on the above studies and the current guidelines of the Centers for Disease Control and Prevention (CDC), treating pregnant women in high-risk populations who are diagnosed with BV provides the clinician with an opportunity to possibly prevent preterm labor in this population. In nulliparous women without a history of preterm birth, treatment is recommended if other risk factors are present (e.g. gonorrhea or chlamydia). However, in the general low-risk populations, routine screening is not indicated.
Tebes
Christine C
CC
Department of Obstetrics and Gynecology, University of South Florida, Tampa, FL 33601-1289, USA.
Lynch
Catherine
C
Sinnott
John
J
D000328:Adult; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D015994:Incidence; D008403:Mass Screening; D015201:Meta-Analysis as Topic; D007752:Obstetric Labor, Premature / Q000453:epidemiology / Q000382:microbiology* / Q000517:prevention & control; D010298:Parity; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious; D011256:Pregnancy Outcome; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D016585:Vaginosis, Bacterial / Q000150:complications* / Q000188:drug therapy*
D000900:Anti-Bacterial Agents