An incident case-referent study of threatening preterm birth and genital infection.

A total of 53 pregnant Mozambican women identified as having painful uterine contractions in the preterm period were studied and compared to referents, matched for age, parity, and gestational length, without such contractions. Both groups were studied regarding socio-economic and obstetric background factors, current clinical features, and microbiological findings in the lower genital tract. Cases tended to seek antenatal care earlier than referents. Salaried work outside the home was more common among cases (OR = 16.9). It was shown that affected cases had significantly more antenatal card risk factors (OR = 3.4) and that 10 times more cases than referents had elevated body temperature (OR = 16.7). Anaemia was more common among cases than among referents (OR = 3.7) and malaria parasitaemia was over-represented among cases (OR = 12.4). Mid-upper-arm circumference was shorter among cases than among referents (OR = 2.4). Anaerobic bacteria tended to be isolated from endocervix more often among cases than among referents (OR = 2.4). Only one woman in the study was HIV-1-positive. It is concluded that febrile infection is strongly associated with preterm labour and that salaried work outside home, anaemia, and malaria are significant risk factors in the setting studied.