title: The relationship between resolution of asymptomatic bacterial vaginosis and spontaneous preterm birth in fetal fibronectin-positive women.
abstract: OBJECTIVE
  The purpose of this study was to determine the impact of persistent bacterial vaginosis (BV) on the occurrence of spontaneous preterm birth (SPB) in women who test positive for fetal fibronectin.
  
  
  METHODS
  This is a secondary analysis of a subset of pregnant women who tested positive for BV and fetal fibronectin between 16(0/7) and 25(6/7) weeks of gestation and who participated in randomized placebo controlled trials of antibiotic therapy. Nugent's criteria were used for the diagnosis of BV. Patients were reassessed for the presence of BV after treatment. The rate of SPB at <34 weeks of gestation was analyzed on the basis of treatment mode and BV status at the follow-up visit.
  
  
  RESULTS
  The primary studies included a total of 3285 women. A subset of 215 women met the criteria for this analysis. Seventy-seven of 100 patients (77%) in the antibiotics group vs 33 of the 115 patients (28.7%) in the placebo group became BV negative (P < .0001). The rate of SPB at <34 weeks of gestation was lower for BV resolution compared with persistent BV (0 vs 5.7%, respectively; P = .01).
  
  
  CONCLUSIONS
  In women who tested positive for fetal fibronectin and BV, resolution of BV is associated with less SPB before 34 weeks of gestation.
authors.affiliation: Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI 48201, USA. ihendler@med.wayne.edu
authors.forename: Israel
authors.initials: I
authors.lastname: Hendler
authors.forename: William W
authors.initials: WW
authors.lastname: Andrews
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Carey
authors.forename: Mark A
authors.initials: MA
authors.lastname: Klebanoff
authors.forename: William D
authors.initials: WD
authors.lastname: Noble
authors.forename: Baha M
authors.initials: BM
authors.lastname: Sibai
authors.forename: Sharon L
authors.initials: SL
authors.lastname: Hillier
authors.forename: Donald
authors.initials: D
authors.lastname: Dudley
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Ernest
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Leveno
authors.forename: Ronald
authors.initials: R
authors.lastname: Wapner
authors.forename: Jay D
authors.initials: JD
authors.lastname: Iams
authors.forename: Michael
authors.initials: M
authors.lastname: Varner
authors.forename: Atef
authors.initials: A
authors.lastname: Moawad
authors.forename: Menachem
authors.initials: M
authors.lastname: Miodovnik
authors.forename: Mary J
authors.initials: MJ
authors.lastname: O'Sullivan
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Van Dorsten
mesh_terms: D000328:Adult; D000890:Anti-Infective Agents / Q000627:therapeutic use; D015897:Comorbidity; D005260:Female; D005353:Fibronectins / Q000032:analysis; D006801:Humans; D008795:Metronidazole / Q000627:therapeutic use; D011247:Pregnancy; D047928:Premature Birth / Q000453:epidemiology* / Q000517:prevention & control; D016585:Vaginosis, Bacterial / Q000188:drug therapy / Q000453:epidemiology*
chemical_list: D000890:Anti-Infective Agents; D005353:Fibronectins; D008795:Metronidazole