Prevention of preterm birth is possible by vaginal pH screening, early diagnosis of bacterial vaginosis or abnormal vaginal flora and treatment.
Abnormal vaginal flora as well as bacterial vaginosis have a significant relative risk for miscarriage or preterm birth of 1.4-6.9. In the initial Erfurt trial, 0.3% of the neonates with gestational age <32+0 weeks were seen in an intervention group vs. 3.3% (p < 0.01) in the control group; in the larger Thuringia campaign, the figures were 0.94 vs. 1.36% (p < 0.01). The rate of newborns <1,000 g was reduced to 0.38%, the lowest incidence ever seen in any of the German states. This should count even more, as there was no success in reducing the rate of low-birth-weight children in the decades preceding these prospective studies. However, after discontinuation of the campaign in 2000, the preterm birth rates mounted in 2005 in our hospital and the state to the same rate as prior to the programme.
Department of Obstetrics and Gynecology, HELIOS Klinikum Erfurt GmbH, Erfurt, Germany. udo.hoyme @ helios-kliniken.de
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D000022:Abortion, Spontaneous / Q000382:microbiology / Q000517:prevention & control; D000282:Administration, Intravaginal; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001724:Birth Weight; D005260:Female; D005858:Germany / Q000453:epidemiology; D005865:Gestational Age; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007231:Infant, Newborn; D007234:Infant, Premature; D007778:Lactobacillus; D011247:Pregnancy; D047928:Premature Birth / Q000453:epidemiology / Q000382:microbiology* / Q000517:prevention & control*; D019936:Probiotics / Q000627:therapeutic use; D012307:Risk Factors; D012648:Self Care; D014621:Vagina / Q000737:chemistry* / Q000382:microbiology*; D016585:Vaginosis, Bacterial / Q000175:diagnosis* / Q000188:drug therapy*
D000900:Anti-Bacterial Agents