Association between bacterial vaginosis and preterm delivery of a low-birth-weight infant
Association between bacterial vaginosis and preterm delivery of a low-birth-weight infant
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DOI：
10.1056/nejm199512283332604
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发表时间：
1995-12-28
影响因子：
158.5
通讯作者：
Klebanoff, MA
中科院分区：
文献类型：
--
作者：
Hillier, SL;Nugent, RP;Klebanoff, MA
背景。细菌性阴道病被认为是早产的危险因素。在考虑了其他已知的危险因素后，我们对细菌性阴道病与低出生体重婴儿早产之间的关联进行了一项研究。方法。在这项队列研究中，我们招募了来自 7 个医疗中心的 10,397 名孕妇，她们没有已知的早产医疗风险因素。妊娠23至26周时，根据阴道pH值和革兰氏染色结果确定是否存在细菌性阴道病。主要结果变量是在妊娠 37 周以内分娩出生体重低于 2500 克的婴儿。结果。在 10,397 名女性中，16% 的人检测出细菌性阴道病。患有细菌性阴道病的女性更有可能未婚、黑人、低收入以及曾经生育过低出生体重婴儿。在多变量分析中，细菌性阴道病的存在与低出生体重婴儿的早产有关（优势比为 1.4；95% 置信区间为 1.8）。与该人群中此类分娩显着相关的其他危险因素包括先前分娩过低出生体重婴儿（比值比，6.2；95%置信区间，4.6至8.4）、早期妊娠流产（比值比，1.7、1.3至2.2）、初产妇（比值比，1.6；1.1至1.9）、吸烟（比值比， 1.4、1.1至1.7)；和黑人种族（比值比，1.4；1.1 至 1.7）。在患有细菌性阴道病的女性中，同时患有阴道拟杆菌和人型支原体的女性中，低出生体重婴儿早产的风险最高（比值比，2.1；95% 置信区间，1.5 至 3.0）。结论。细菌性阴道病与低出生体重婴儿的早产有关，与其他公认的危险因素无关。
Background. Bacterial vaginosis is believed to be a risk factor for preterm delivery. We undertook a study of the association between bacterial vaginosis and the preterm delivery of infants with low birth weight after accounting for other known risk factors.Methods. In this cohort study, we enrolled 10,397 pregnant women from seven medical centers who had no known medical risk factors for preterm delivery. At 23 to 26 weeks' gestation, bacterial vaginosis was determined to be present or absent on the basis of the vaginal pH and the results of Gram's staining. The principal outcome variable was the delivery at less than 37 weeks' gestation of an infant with a birth weight below 2500 g.Results. Bacterial vaginosis was detected in 16 percent of the 10,397 women. The women with bacterial vaginosis were more likely to be unmarried, to be black, to have low incomes, and to have previously delivered low-birth-weight infants. In a multivariate analysis, the presence of bacterial vaginosis was related to preterm delivery of a low-birth-weight infant (odds ratio, 1.4; 95 percent confidence interval to 1.8). Other risk factors that were significantly associated with such a delivery in this population were the previous delivery of a low-birthweight infant (odds ratio, 6.2; 95 percent confidence interval, 4.6 to 8.4), the loss of an earlier pregnancy (odds ratio, 1.7, 1.3 to 2.2), primigravidity (odds ratio, 1.6; 1.1 to 1.9), smoking (odds ratio, 1.4, 1.1 to 1.7); and black race (odds ratio, 1.4; 1.1 to 1.7). Among women with bacterial vaginosis, the highest risk of preterm delivery of a low-birth-weight infant was found among those with both vaginal bacteroides and Mycoplasma hominis (odds ratio, 2.1; 95 percent confidence interval, 1.5 to 3.0).Conclusions. Bacterial vaginosis was associated with the preterm delivery of low-birth-weight infants independently of other recognized risk factors.