French J I, McGregor J A, Draper D, Parker R, McFee J
Department of Obstetrics and Gynecology at Denver Health Medical Center, and the University of Colorado Health Sciences Center, 80204, USA.
Obstet Gynecol. 1999 May;93(5 Pt 1):715-24. doi: 10.1016/s0029-7844(98)00557-2.
To examine associations between bacterial vaginosis and other prevalent lower genital tract infections and clinically recognized first-trimester bleeding; possible independent and joint effects of gestational bleeding and bacterial vaginosis or other prevalent infections on preterm birth and premature rupture of membranes; and effects of antimicrobial treatment on reducing risks of preterm birth among these women.
A secondary analysis was conducted of 1100 pregnant women enrolled in a prospective observational study that examined the effects of standardized diagnosis and treatment of lower genital tract infections to prevent preterm birth.
Sixty percent of women with first-trimester bleeding had one or more study infections detected at the initial examination. First-trimester bleeding was associated independently with the presence of bacterial vaginosis (odds ratio [OR] 1.5, 95% confidence interval [CI] 1.0, 2.3), Trichomonas vaginalis (OR 2.3, 95% CI 1.3, 4.2), and Chlamydia trachomatis (OR 2.7, 95% CI 1.4, 5.1). Preterm birth was increased among women with first-trimester bleeding and bacterial vaginosis (relative risk [RR] 4.4, 95% CI 2.0, 9.5) and bacterial vaginosis and T vaginalis (RR 3.0, 95% CI 1.0, 8.8). Systemic antimicrobial treatment reduced the rate of preterm birth among women with bacterial vaginosis without first-trimester bleeding (RR 0.37, 95% CI 0.16, 0.88). Treatment of women with both first-trimester bleeding and bacterial vaginosis reduced preterm birth (RR 0.52, 95% CI 0.18, 1.55), but not significantly.
First-trimester bleeding was increased among women with bacterial vaginosis, T vaginalis, C trachomatis, and combinations of these infections. Women with bacterial vaginosis who also experienced first-trimester bleeding were at heightened risk for preterm birth. Treatment of studied infections reduced significantly the risks of preterm birth among women without first-trimester bleeding.
研究细菌性阴道病与其他常见的下生殖道感染及临床上公认的孕早期出血之间的关联；妊娠出血与细菌性阴道病或其他常见感染对早产和胎膜早破的可能独立及联合影响；以及抗菌治疗对降低这些女性早产风险的作用。
对1100名参与一项前瞻性观察性研究的孕妇进行了二次分析，该研究探讨了下生殖道感染的标准化诊断和治疗对预防早产的影响。
60%的孕早期出血女性在初次检查时检测出一种或多种研究中的感染。孕早期出血与细菌性阴道病（比值比[OR]1.5，95%置信区间[CI]1.0，2.3）、阴道毛滴虫（OR 2.3，95%CI 1.3，4.2）和沙眼衣原体（OR 2.7，95%CI 1.4，5.1）的存在独立相关。孕早期出血且患有细菌性阴道病的女性早产风险增加（相对风险[RR]4.4，95%CI 2.0，9.5），患有细菌性阴道病和阴道毛滴虫的女性早产风险增加（RR 3.0，95%CI 1.0，8.8）。全身抗菌治疗降低了无孕早期出血的细菌性阴道病女性的早产率（RR 0.37，95%CI 0.16，0.88）。对孕早期出血且患有细菌性阴道病的女性进行治疗可降低早产风险（RR 0.52，95%CI 0.18，1.55），但差异不显著。
患有细菌性阴道病、阴道毛滴虫、沙眼衣原体以及这些感染组合的女性孕早期出血风险增加。患有细菌性阴道病且经历孕早期出血的女性早产风险更高。对所研究感染的治疗显著降低了无孕早期出血女性的早产风险。
