Honda Hiroshi, Yokoyama Takanori, Akimoto Yumiko, Tanimoto Hirotoshi, Teramoto Mitsue, Teramoto Hideki
Department of Obstetrics and Gynecology, Hiroshima City Asa Hospital, Hiroshima, Japan.
Sci Rep. 2014 Apr 25;4:4799. doi: 10.1038/srep04799.
The effect of screening and treatment for abnormal vaginal flora on the reduction of preterm deliveries remains controversial. We evaluated whether this screening and treatment reduces the preterm delivery rate for general-population pregnant women. Pregnant women of the Intervention group (n = 574) underwent the screening test and the treatment of vaginal metronidazole during the early second trimester, and those of the Control group (n = 1,161) did not. We compared the preterm delivery rate between these two groups. We also compared the profiles of vaginal flora of the preterm delivery cases with those of the pregnant women with a normal course. There was no significant difference in the preterm delivery rate between these two groups. However, in the preterm delivery cases, a frequent shift to intermediate flora was observed not before but after the screening in the Intervention group. This shift may explain why most of the previous studies failed in regard to the prevention of preterm deliveries.
阴道阴道异常阴道菌群的筛查和治疗对降低早产率的影响仍存在争议。我们评估了这种筛查和治疗是否能降低普通人群孕妇的早产率。干预组（n = 574）的孕妇在孕中期早期接受了筛查测试并接受了阴道甲硝唑治疗，而对照组（n = 1,161）的孕妇则没有。我们比较了这两组之间的早产率。我们还比较了早产病例与正常妊娠孕妇的阴道菌群特征。两组之间的早产率没有显著差异。然而，在早产病例中，干预组在筛查后而非筛查前观察到频繁向中间型菌群转变。这种转变可能解释了为什么之前的大多数研究在预防早产方面失败。
