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Infection, antibiotics, and preterm delivery.

G Locksmith1, P Duff

  • 1Division of Maternal-Fetal Medicine, University of Texas Medical Branch--Galveston, 77555-0587, USA.

Seminars in Perinatology
|November 15, 2001
PubMed
Summary

Treating genital tract infections in pregnant women can lower the risk of preterm birth. Screening for infections like bacterial vaginosis and chlamydia is recommended for early intervention and improved pregnancy outcomes.

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Area of Science:

  • Obstetrics and Gynecology
  • Infectious Diseases
  • Maternal-Fetal Medicine

Background:

  • Genital tract infections are linked to preterm delivery through inflammation and microbial activity.
  • Evidence suggests microorganisms and host responses trigger preterm labor and membrane rupture.

Purpose of the Study:

  • To review the evidence on the relationship between genital tract infections and preterm delivery.
  • To evaluate the efficacy of treating various infections to reduce preterm birth risk.

Main Methods:

  • Review of biochemical, microbiological, clinical, and epidemiologic studies.
  • Analysis of in vitro studies and antibiotic treatment trials.

Main Results:

  • Treatment of asymptomatic bacteriuria and symptomatic infections (bacterial vaginosis, trichomoniasis, gonorrhea, chlamydia) can lower preterm delivery risk.
  • Prophylactic antibiotics are beneficial in preterm premature rupture of membranes to prolong latency and reduce infection.
  • Antibiotics are not recommended for prolonging pregnancy in preterm labor, except for preventing Group B Streptococcus sepsis.

Conclusions:

  • Pregnant women with abnormal discharge should be tested for BV, trichomonas, gonorrhea, and chlamydia.
  • Antibiotic treatment for asymptomatic bacteriuria is indicated.
  • Routine screening for chlamydia and gonorrhea in high-risk women is advised; routine BV screening in low-risk women is not supported by current evidence.

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