Brocklehurst P, Hannah M, McDonald H
National Perinatal Epidemiology Unit, Institute of Health Sciences, Old Road, Headington, Oxford, UK, OX3 7LF.
Cochrane Database Syst Rev. 2000(2):CD000262. doi: 10.1002/14651858.CD000262.
Bacterial vaginosis has been associated with poor perinatal outcome. Since the infections are amenable to treatment, identification during pregnancy and treatment may reduce the risk of preterm birth and its consequences.
The objective of this review was to assess the effects of antibiotic treatment of bacterial vaginosis in pregnancy.
We searched the Cochrane Pregnancy and Childbirth Group trials register and the Cochrane Controlled Trials Register.
Randomised trials comparing one antibiotic regimen with placebo or no treatment, or which compare two or more alternative antibiotic regimens in pregnant women with bacterial vaginosis.
Trial quality assessments and data extraction were done independently by three reviewers. Study authors were contacted for additional information.
Five trials involving 1504 women were included. These trials were of good quality. Antibiotic therapy was highly effective at eradicating infection during pregnancy as judged by 'test-of-cure' following therapy (odds ratio 0.22, 95% confidence interval 0.17 to 0.27). The effect of treating bacterial vaginosis during pregnancy showed a trend to less births before 37 weeks gestation (odds ratio 0.78, 95% confidence interval 0.60 to 1.02). The prevention of preterm birth less than 37 weeks gestation was most marked in the subgroup of women with a previous preterm birth (odds ratio 0.37, 95% confidence interval 0.23 to 0. 60).
REVIEWER'S CONCLUSIONS: The current evidence does not support screening and treating all pregnant women for bacterial vaginosis to prevent preterm birth and its consequences. For women with a history of a previous preterm birth there is some suggestion that detection and treatment of bacterial vaginosis early in pregnancy may prevent a proportion of these women having a further preterm birth. It is not known whether this is associated with an improvement in neonatal well-being.
细菌性阴道病与不良围产期结局相关。由于这些感染易于治疗，孕期识别并治疗可能降低早产风险及其后果。
本综述的目的是评估孕期抗生素治疗细菌性阴道病的效果。
我们检索了Cochrane妊娠与分娩组试验注册库和Cochrane对照试验注册库。
比较一种抗生素方案与安慰剂或不治疗，或比较两种或更多替代抗生素方案用于患有细菌性阴道病的孕妇的随机试验。
由三位评价员独立进行试验质量评估和数据提取。联系研究作者获取更多信息。
纳入了五项涉及1504名女性的试验。这些试验质量良好。根据治疗后的“治愈试验”判断，抗生素治疗在孕期根除感染方面非常有效（比值比0.22，95%置信区间0.17至0.27）。孕期治疗细菌性阴道病的效果显示出在妊娠37周前分娩较少的趋势（比值比0.78，95%置信区间0.60至1.02）。预防妊娠小于37周的早产在有既往早产史的女性亚组中最为显著（比值比0.37，95%置信区间0.23至0.60）。
目前的证据不支持对所有孕妇进行细菌性阴道病筛查和治疗以预防早产及其后果。对于有既往早产史的女性，有一些迹象表明孕期早期检测和治疗细菌性阴道病可能预防一部分此类女性再次早产。尚不清楚这是否与新生儿健康改善有关。
