妊娠中の女性におけるバクテリア性ヴァギノシスのスクリーニング:米国予防サービスタスクフォースの勧告声明
, Douglas K Owens1,2, Karina W Davidson3
1Veterans Affairs Palo Alto Health Care System, Palo Alto, California.
JAMA
|April 8, 2020
まとめ
妊娠中におけるバクテリア性ヴァギノシスのスクリーニングは,早産のリスクが高くありません. リスクが高い人にとって 利益と害を判断するには 証拠は不十分です
科学分野:
- 産婦人科
- 感染症
- 予防 医療
背景:
- バクテリア性陰道炎 (BV) は 下部生殖器の微生物群を破壊し,妊娠した女性に影響します.
- 米国では5.8%から19.3%の割合で,特定の人口集団ではより高い割合です.
- 妊娠中のVBは,早産,流産,低出生体重などの有害な結果と関連しています.
研究 の 目的:
- 症状のない妊婦の BV のスクリーニングに関する 2008 年の勧告を更新する.
- 検診の精度に関する証拠と,早産防止のためのVB検診と治療の利益/害を評価する.
主な方法:
- USPSTFが依頼した証拠の 体系的な調査
- スクリーニングテストの精度とスクリーニングと治療の臨床結果に焦点を当てた.
- 無症状の妊婦は含め,早産のリスクが高い者についてはサブグループ分析を行いました.
主要な成果:
- 早期出産のリスクが増加しない症状のない妊婦のスクリーニングは,純利益をもたらさないという中程度の確実性.
- 早期出産のリスクが高い人にとって 利益と害に関する 矛盾し,不十分な証拠
結論:
- USPSTFは,早産のリスクが増加していない妊婦の BVスクリーニングを推奨していません (D勧告).
- 早期出産のリスクが高い妊婦のスクリーニングの利益と害のバランスを評価するには,証拠は不十分である (I声明).
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