RT Journal Article
SR Electronic
T1 Bacterial vaginosis and preterm birth: a prospective community-based cohort study.
JF British Journal of General Practice
JO Br J Gen Pract
FD British Journal of General Practice
SP 119
OP 122
VO 54
IS 499
A1 Pippa Oakeshott
A1 Sally Kerry
A1 Sima Hay
A1 Philip Hay
YR 2004
UL http://bjgp.org/content/54/499/119.abstract
AB BACKGROUND: Preterm birth before 37 weeks' gestation is associated with 70% of perinatal morbidity and nearly half of long-term neurological morbidity. Hospital-based studies have shown that bacterial vaginosis is associated with preterm birth. AIM: To estimate the relative risk of preterm birth in women with and without bacterial vaginosis, detected by self-administered vaginal swab at < 10 weeks' gestation. DESIGN: Prospective cohort study. SETTING: Thirty-two general practices and five family planning clinics in South London. PARTICIPANTS: A total of 1216 women with bacterial vaginosis status established before 10 weeks' gestation, by analysis of Gram stained vaginal smears by two independent observers. METHOD: All women who did not miscarry or have a termination of pregnancy before 16 weeks' gestation were sent a brief confidential questionnaire at 16 weeks and at term asking about pregnancy outcome. Data on non-responders were obtained by searches of hospital and general practice records and by telephone calls to patients. RESULTS: Ascertainment was 87% (937/1072). The mean age of the women was 31 years. Thirteen per cent (122/925) had bacterial vaginosis and 5% (44/897) had a spontaneous preterm birth. The relative risk (RR) of preterm birth in women with bacterial vaginosis was 0.9 (95% confidence interval [CI] = 0.4 to 2.2). However, bacterial vaginosis was associated with late miscarriage at 13-23 weeks (R = 4.0, 95%CI = 1.3 to 12.1). Preterm birth was not associated with previous preterm birth, black ethnicity, age < 20 years, low social class, single marital status, or chlamydial infection. However, it was more common in women who reported smoking in pregnancy (RR = 2.9, 95% CI = 1.5 to 5.5). Of 867 responders, 552 (64%) said that providing a vaginal swab was at least as easy as providing a urine specimen. CONCLUSIONS: In this low-risk community-based cohort, bacterial vaginosis was not a strong risk factor for preterm birth.