American Journal of Obstetrics & Gynecology
Volume 197, Issue 5 , Pages 488.e1-488.e5, November 2007

The relationship between resolution of asymptomatic bacterial vaginosis and spontaneous preterm birth in fetal fibronectin–positive women

Presented at the 25th Annual Meeting of the Society for Maternal–Fetal Medicine, Reno, NV, Feb. 7-12, 2005.

  • Israel Hendler, MD

      Affiliations

    • Departments of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI
    • Corresponding Author InformationReprints: Israel Hendler, MD, Division of Maternal-Fetal-Medicine, Department of Obstetrics and Gynecology, Hutzel Hospital-Wayne State University, 3990 John R St, Detroit, MI, 48201
    • ,
  • William W. Andrews, MD, PhD

      Affiliations

    • University of Alabama at Birmingham School of Medicine, Birmingham, AL
    • ,
  • Christopher J. Carey, MD

      Affiliations

    • University of Oklahoma College of Medicine, Oklahoma City, OK
    • ,
  • Mark A. Klebanoff, MD

      Affiliations

    • National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD
    • ,
  • William D. Noble, PhD

      Affiliations

    • George Washington University Medical Center, Washington, DC
    • ,
  • Baha M. Sibai, MD

      Affiliations

    • Departments of Obstetrics and Gynecology, the University of Tennessee Health Science Center College of Medicine, Memphis, TN
    • ,
  • Sharon L. Hillier, PhD

      Affiliations

    • University of Pittsburgh School of Medicine, Pittsburgh, PA
    • ,
  • Donald Dudley, MD

      Affiliations

    • University of Texas Health Science Center at San Antonio School of Medicine, San Antonio, TX
    • ,
  • Joseph M. Ernest, MD

      Affiliations

    • Wake Forest University School of Medicine, Winston-Salem, NC
    • ,
  • Kenneth J. Leveno, MD

      Affiliations

    • University of Texas Southwestern Medical Center, Dallas, TX
    • ,
  • Ronald Wapner, MD

      Affiliations

    • Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA
    • ,
  • Jay D. Iams, MD

      Affiliations

    • Ohio State University College of Medicine, Columbus, OH
    • ,
  • Michael Varner, MD

      Affiliations

    • University of Utah School of Medicine, Salt Lake City, UT
    • ,
  • Atef Moawad, MD

      Affiliations

    • Pritzker School of Medicine, University of Chicago, Chicago, IL
    • ,
  • Menachem Miodovnik, MD

      Affiliations

    • University of Cincinnati College of Medicine, Cincinnati, OH
    • ,
  • Mary J. O’Sullivan, MD

      Affiliations

    • Leonard M. Miller School of Medicine, University of Miami, Miami, FL
    • ,
  • Peter J. Van Dorsten, MD

      Affiliations

    • Medical University of South Carolina, Charleston, SC.
    • ,
  • National Institute of Child Health and Human Development, Maternal-Fetal Medicine Units Network

Received 7 October 2006; accepted 26 March 2007.

Objective

The purpose of this study was to determine the impact of persistent bacterial vaginosis (BV) on the occurrence of spontaneous preterm birth (SPB) in women who test positive for fetal fibronectin.

Study Design

This is a secondary analysis of a subset of pregnant women who tested positive for BV and fetal fibronectin between 160/7 and 256/7 weeks of gestation and who participated in randomized placebo controlled trials of antibiotic therapy. Nugent’s criteria were used for the diagnosis of BV. Patients were reassessed for the presence of BV after treatment. The rate of SPB at <34 weeks of gestation was analyzed on the basis of treatment mode and BV status at the follow-up visit.

Results

The primary studies included a total of 3285 women. A subset of 215 women met the criteria for this analysis. Seventy-seven of 100 patients (77%) in the antibiotics group vs 33 of the 115 patients (28.7%) in the placebo group became BV negative (P < .0001). The rate of SPB at <34 weeks of gestation was lower for BV resolution compared with persistent BV (0 vs 5.7%, respectively; P = .01).

Conclusion

In women who tested positive for fetal fibronectin and BV, resolution of BV is associated with less SPB before 34 weeks of gestation.

Key words: antibiotic treatment, bacterial vaginosis, fetal fibronectin, preterm birth

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 Supported by grants from the National Institute of Child Health and Human Development (HD27869, HD21414, HD36801, HD34208, HD27860, HD34116, HD34136, HD27861, HD34122, HD21410, HD27915, HD34210, HD27905, HD27917, HD21410, HD27883, HD27889, HD19897) and by a grant from the National Institute of Allergy and Infectious Diseases (AI 38514).Cite this article as: Hendler I, Andrews WW, Carey CJ, et al. The relationship between resolution of asymptomatic bacterial vaginosis and spontaneous preterm birth in fetal fibronectin–positive women. Am J Obstet Gynecol 2007;197:488.e1-488.e5.

PII: S0002-9378(07)00471-1

doi:10.1016/j.ajog.2007.03.073

American Journal of Obstetrics & Gynecology
Volume 197, Issue 5 , Pages 488.e1-488.e5, November 2007

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