Hay P E, Lamont R F, Taylor-Robinson D, Morgan D J, Ison C, Pearson J
Division of Sexually Transmitted Diseases, Clinical Research Centre, Harrow, Middlesex.
BMJ. 1994 Jan 29;308(6924):295-8. doi: 10.1136/bmj.308.6924.295.
To find out whether women with bacterial vaginosis detected early in pregnancy are at increased risk of preterm delivery.
Prospective description cohort study.
Antenatal clinic in a district general hospital.
783 women examined during their first antenatal clinic visit and screened for recognised risk factors for preterm delivery and the presence of bacterial vaginosis or intermediate abnormal flora detected by examination of a vaginal smear stained by Gram's method.
Gestational age at delivery classified as late miscarriage (16-24 weeks' gestation), preterm delivery (24-37 weeks' gestation), term delivery (> or = 37 weeks' gestation).
Multiple logistic analysis showed that there was an increased incidence of preterm delivery in women with a previous preterm delivery (9/24; odds ratio 25; 95% confidence interval 9 to 70; P < 0.001) and bacterial vaginosis (9/115; 2.8; 1.1 to 7.4; P = 0.04). A further logistic analysis of data from women recruited before 16 weeks' gestation showed that preterm deliveries or late miscarriages occurred more often in women with bacterial vaginosis (12/77; 5.5; 2.3 to 13.3; P < 0.001).
Late miscarriage and preterm delivery are associated with the presence of bacterial vaginosis in early pregnancy. This is independent of recognised risk factors such as previous preterm delivery.
探究妊娠早期检测出细菌性阴道病的女性早产风险是否增加。
前瞻性描述性队列研究。
地区综合医院的产前诊所。
783名女性，她们在首次产前诊所就诊时接受检查，筛查早产的公认风险因素以及通过革兰氏染色法检查阴道涂片检测出的细菌性阴道病或中间型异常菌群。
分娩时的孕周分类为晚期流产（妊娠16 - 24周）、早产（妊娠24 - 37周）、足月分娩（≥37周妊娠）。
多因素逻辑回归分析显示，既往有早产史的女性（9/24；比值比25；95%置信区间9至70；P < 0.001）和患有细菌性阴道病的女性（9/115；2.8；1.1至7.4；P = 0.04）早产发生率增加。对妊娠16周前招募的女性数据进行的进一步逻辑回归分析表明，患有细菌性阴道病的女性早产或晚期流产更为常见（12/77；5.5；2.3至13.3；P < 0.001）。
晚期流产和早产与妊娠早期细菌性阴道病的存在有关。这与既往早产等公认风险因素无关。
