General Obstetrics and Gynecology ObstetricsBacterial vaginosis as a risk factor for preterm delivery: A meta-analysis☆
Section snippets
Material and methods
In July 2001, we searched MEDLINE entries from 1966 to the present, EMBASE from 1988 to the present, and SCIENCE CITATION INDEX EXPANDED from 1997 to the present to identify all literature that was included (vaginitis or vaginosis or vagina* infection or vagina* inflammation or “Vaginosis-Bacterial”/ explode or “Vaginitis”/explode) and (pregnan* or gravid* or birth? or labo?r? or “Pregnancy”/explode or “Labor”/explode). The following criteria were used to select studies for inclusion: article
Results
A total of 18 studies with results for 20,232 patients were included.3, 6, 7, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26 For 1 of the studies, the “Preterm Prediction Study” (a large study that was carried out by the National Institute of Child Health and Human Development), numerous reports were published. Three of these studies were used to extract results for the outcomes of delivery at <37 weeks of gestation,3 <35 weeks of gestation,23 or <32 weeks of gestation3 and
Comment
The results of this meta-analysis confirm that BV is associated significantly with adverse pregnancy outcome and that the risk of preterm delivery at <37 weeks of gestation, as calculated in the main analysis, is >2-fold in women with BV. The considerable and highly significant statistical heterogeneity that was seen in this main analysis, however, makes it clear that this combined result is only a crude estimate of the strength of the association between BV and preterm birth, but it has no
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Reprint requests: Harald Leitich, MD, PhD, Department of Obstetrics and Gynecology, University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria. E-mail: [email protected]