title: Treatment of bacterial vaginosis does not reduce preterm birth among high-risk asymptomatic women in fetal fibronectin positive patients.
abstract: OBJECTIVE
  Bacterial vaginosis (BV) is associated with preterm labor and may be positive in 15% of asymptomatic high-risk women. Fetal fibronectin (fFN) has been shown in symptomatic women to predict infection-related preterm birth. The purpose of this study was to quantitate the relationship between BV/fFN and preterm delivery in high-risk asymptomatic women.
  
  
  METHODS
  Women at high-risk for spontaneous preterm delivery were tested for BV/fFN between 20-28 weeks gestation. Women positive for BV were treated with metronidazole, and fFN results were not used by physicians in treatment. After delivery, test results and pregnancy outcomes were entered in a deidentified database and analyzed.
  
  
  RESULTS
  Of 232 women tested for BV/fFN over a 24-month epoch, results divided participants into 4 groups: Group A (N = 12; +BV/+fFN); Group B (N = 22; -BV/+fFN); Group C (N = 68; +BV/-fFN); and Group D (N = 130; -BV/-fFN). Demographics were the same between the 4 groups (P = NS) as was the gestational age at delivery (36.41 +/- 3.96 to 37.18 +/- 3.03 weeks). The incidence ofpreterm labor (P = .075), spontaneous early delivery (P = .936) and infants < 2500 gm (P = .664) was also similar.
  
  
  CONCLUSIONS
  In asymptomatic high-risk women, testing for fFN/BV during mid-pregnancy does not appear warranted.
authors.affiliation: Willis Knighton Health System, 9111 Susan Drive, Shreveport, LA 71118, USA. Christianbriery@hotmail.com
authors.forename: Christian M
authors.initials: CM
authors.lastname: Briery
authors.forename: Suneet P
authors.initials: SP
authors.lastname: Chauhan
authors.forename: Everett F
authors.initials: EF
authors.lastname: Magann
authors.forename: Julie L
authors.initials: JL
authors.lastname: Cushman
authors.forename: John C
authors.initials: JC
authors.lastname: Morrison
mesh_terms: D000328:Adult; D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001034:Apgar Score; D001724:Birth Weight; D016009:Chi-Square Distribution; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005326:Fetal Proteins / Q000032:analysis*; D005353:Fibronectins / Q000032:analysis*; D005865:Gestational Age; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007231:Infant, Newborn; D008423:Maternal Age; D008795:Metronidazole / Q000008:administration & dosage / Q000627:therapeutic use*; D010298:Parity; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy*; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000517:prevention & control*; D016032:Randomized Controlled Trials as Topic; D018709:Statistics, Nonparametric; D013997:Time Factors; D016585:Vaginosis, Bacterial / Q000188:drug therapy
chemical_list: D000890:Anti-Infective Agents; D005326:Fetal Proteins; D005353:Fibronectins; D008795:Metronidazole