Bacterial Vaginosis and Spontaneous Abortion

描述：细菌性阴道病(BV)在低收入人群中极为普遍， 城市孕妇。目前的医疗标准不包括 除非报告临床症状，否则对孕妇进行BV筛查；然而， 大多数患有BV的孕妇都没有症状。多项研究 已经发现BV和晚期妊娠结局之间的联系；例如， 早产、胎膜早破、绒毛膜羊膜炎和低产 重量。BV对自然流产(SAB)风险的影响尚不清楚。 在拟议的前瞻性队列研究中，将对所有妇女进行BV筛查 在怀孕早期，不考虑症状。这项研究的具体目的是 TO：1)描述早期女性BV的患病率和预测因素 以及2)评估怀孕期间的BV是否重要， SAB的独立预测因子。参加第一次临床产前检查的妇女 宾夕法尼亚大学产科诊所医院的护理访问 根据最后一次月经确定怀孕12周或以下的 期间将被招募。我们将对所有女性进行细菌性阴道病筛查， 对怀孕22周的妇女进行随访以确定是否经历了 自然流产。我们将在三年内招收2200名妇女 比较大约400名被发现检测为阳性的妇女的SAB发生率(20 %的患者)和1600名妇女被发现检测结果为阴性。基线 数据收集将标准化，并包括结构化的面对面 访谈、阴道涂片用于检测，并进行尿液分析以确定 酒精、可卡因和可替宁。跟进电话访问将会进行 在妊娠22周时确定妊娠状态(SAB与非SAB) 以及BV的诊断和治疗。怀孕结局状态也将是 通过持续审查医疗记录、病理记录和出生情况确定 证书。初步分析将是探索性和描述性的， 描述BV的流行率和预测因素，以及 SAB。主要分析将是Logistic回归，具有相对风险和 95%的可信区间，以探索BV是否为独立的 SAB的预测因子。这项研究将提供一个独特的机会来评估 BV在孕妇中的患病率与确定两者之间的关系 BV和事件SAB。

DESCRIPTION: Bacterial vaginosis (BV) is extremely prevalent among low-income, urban pregnant women. The current standard of medical care does not involve screening pregnant women for BV unless clinical symptoms are reported; however, the majority of pregnant women with BV are asymptomatic. A number of studies have found associations between BV and late pregnancy outcomes; such as, preterm labor, premature rupture of membrane, chorioamnionitis, and low birth weight. The impact of BV on the risk for spontaneous abortion (SAB) is unclear. In the proposed prospective cohort study, all women will be screened for BV early in pregnancy regardless of symptoms. The specific aims of this study are to: 1) characterize the prevalence and predictors of BV in women early in pregnancy and 2) evaluate whether BV during pregnancy is an important, independent predictor of SAB. Women attending their first clinical prenatal care visit at the Hospital of the University of Pennsylvania Obstetric Clinic with a pregnancy of 12 weeks gestation or less as determined by last menstrual period will be recruited. We will screen all women for bacterial vaginosis and follow-up through 22 weeks gestation to identify women experiencing a spontaneous abortion. We will enroll 2200 women over a three year period arid compare SAB rates for the estimated 400 women found to test positive for BY (20 percent of patients) and the 1600 women found to test negative for By. Baseline data collection will be standardized and include a structured in-person interview, a vaginal smear used to detect By, and urine analysis to determine alcohol, cocaine and cotinine. Follow-up telephone interviews will be conducted at 22 weeks gestation to determine the status of pregnancy (SAB vs. non-SAB) and BV diagnosis and treatment. Pregnancy outcome status will also be ascertained through ongoing review of medical records, pathology logs and birth certificates. Initial analyses will be exploratory and descriptive, characterizing the prevalence and predictors of BV and the risk factors for SAB. The primary analysis will be logistic regression, with relative risks and 95 percent confidence intervals, to explore whether BV is an independent predictor of SAB. This study will provide a unique opportunity to evaluate the prevalence of BV among pregnant women and to determine the relationship between BV and incident SAB.