Infection and prematurity and the role of preventive strategies.

This article reviews the role of infection in spontaneous premature parturition, the pathways of ascending intrauterine infection, microbiology, and the frequency of intra-amniotic infection in obstetrical complications leading to premature delivery. The evidence that infection is causally linked to premature birth is critically examined, as is the relationship between urogenital tract infection/colonization with microorganisms and the risk of preterm birth. The effect of antibiotic administration in perinatal outcome in patients with preterm labor and intact membranes, preterm premature rupture of membranes, asymptomatic bacteriuria, Group B streptococcus and genital mycoplasmas of the lower genital tract, and bacterial vaginosis are critically examined.