Data Analysis From The Vaginal Infections And Prematurit

阴道感染与早产（VIP）研究是由NICHD和NIAID联合发起的一项前瞻性研究，旨在探讨各种微生物在生殖道定植与早产后续发展之间的关系。它还纳入了一项红霉素的临床试验，以预防感染解脲支原体、沙眼衣原体和B群链球菌的妇女早产。此外，VIP还收集了大量可能与妊娠结局有关的各种因素的额外数据。迄今为止进行的分析包括阴道革兰氏染色对B群链球菌鉴定的预测价值、B群链球菌携带的描述性流行病学、报告的体育活动与早产之间的关系、红霉素治疗对B群链球菌感染妇女妊娠结局的影响。不同生殖系统微生物定植的妇女妊娠期性交与早产的关系、B群链球菌定植对妊娠结局的影响、细菌性阴道病与妊娠结局的关系、红霉素治疗对沙眼衣原体定植妇女妊娠结局的影响以及生殖系统菌群的种族差异。

The Vaginal Infections and Prematurity (VIP) Study, jointly sponsored by NICHD and NIAID, was a prospective study designed to investigate the relationship between genital tract colonization with various microorganisms and the subsequent development of preterm birth. It also incorporates a clinical trial of erythromycin to prevent preterm birth among women colonized with Ureaplasma urealyticum, Chlamydia trachomatis, and group B streptococcus. In addition, the VIP collected a wealth of additional data on a variety of factors possibly linked to pregnancy outcome. Analyses undertaken to date include the predictive value of vaginal Gram stain in the identification of group B streptococcus, the descriptive epidemiology of group B streptococcal carriage, the relationship between reported physical activity and preterm birth, the effect of treatment with erythromycin on pregnancy outcome among women colonized with group B streptococci, and the association between sexual intercourse during pregnancy and preterm birth among women colonized with different genital microorganisms, effect of group B streptococcal colonization on pregnancy outcome, the association between bacterial vaginosis and pregnancy outcome, the effect of treatment with erythromycin on pregnancy outcome among women colonized with Chlamydia trachomatis, and ethnic differences in genital flora. During 2004, we investigated the association between ethnicity and vaginal pH (elevation of vaginal pH has been associated with adverse pregnancy outcome). We found that among women with normal vaginal flora, blacks had slighly elevated pH compared to whites. However, we also noted that even among the normal range, black women had higher vaginal Gram stain scores (indicating more abnormal flora) than their white counterparts. At comparable values of Gram stain score, the pH of black and white women did not differ significantly. This suggests that pH differences are due to differences in flora, rather than being a directly innate characteristic. We also evaluate whether change in vlora between 26 weeks gestation and delivery is associated with preterm birth. Acquisition of the Gram-negative rods E.coli and K.pneumoniae was associated with a roughly tripled risk of preterm birth. For no other organism was acquisition associated with preterm birth.