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Published on: November 20, 2015
Antenatal microbiologic and maternal risk factors associated with prematurity
J A McGregor1, J I French, R Richter
1Department of Obstetrics and Gynecology, University of Colorado Health Sciences Center, Denver 80262.
American Journal of Obstetrics and Gynecology
|November 1, 1990
Summary
Lower genital tract infections, including bacterial vaginosis and Mycoplasma hominis, significantly increase the risk of preterm labor and preterm birth. Prior preterm birth history is the strongest predictor, highlighting the need for targeted prevention strategies.
Area of Science:
- Obstetrics and Gynecology
- Infectious Diseases
- Maternal-Fetal Medicine
Background:
- Preterm birth remains a leading cause of neonatal morbidity and mortality worldwide.
- Identifying modifiable risk factors for preterm birth is crucial for developing effective prevention strategies.
- Lower genital tract infections are suspected contributors to adverse obstetric outcomes, including preterm labor and birth.
Purpose of the Study:
- To investigate the association between lower genital tract infections and bacterial conditions with obstetric outcomes.
- To evaluate the specific role of bacterial vaginosis, Mycoplasma hominis, and Staphylococcus aureus in preterm labor and birth.
- To determine the predictive value of historical factors and biochemical markers for preterm birth.
Main Methods:
- A prospective study involving 202 pregnant women (gestational age 24 ± 4 weeks).
- Evaluation of lower genital tract infections using Gram stain and culture for bacterial vaginosis, Mobiluncus species, Mycoplasma hominis, and Staphylococcus aureus.
- Assessment of vaginal wash protease levels and collection of historical data including prior preterm birth, abortions, urinary tract infections, and pregnancy complications.
Main Results:
- Bacterial vaginosis increased preterm labor risk (RR 2.6).
- Mycoplasma hominis was associated with preterm labor (RR 1.8) and preterm birth (RR 5.1).
- Staphylococcus aureus was linked to preterm labor (RR 3.1), and multiple bacterial abnormalities increased preterm labor risk (RR 3.3).
- Elevated vaginal protease levels correlated with preterm labor and preterm premature rupture of membranes.
- Prior preterm birth history was the strongest predictor of both preterm labor (RR 3.6) and preterm birth (RR 6.7).
Conclusions:
- Maternal reproductive tract infections and specific bacterial agents are significantly associated with adverse obstetric outcomes.
- These findings refine our understanding of infection-related preterm birth risks.
- The results support the development of targeted treatment trials for the prevention of preterm birth.
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