Data Analysis From The Vaginal Infections And Prematurit

由NICHD和NIAID联合发起的阴道感染和早产（VIP）研究是一项前瞻性研究，旨在研究生殖道定植各种微生物与随后早产发生之间的关系。它还包括一项红霉素预防解脲支原体、沙眼衣原体和B组链球菌定植妇女早产的临床试验。此外，VIP收集了大量关于可能与妊娠结局相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在鉴定B组链球菌中的预测价值，B组链球菌携带的描述性流行病学，报告的体力活动与早产之间的关系，红霉素治疗对B组链球菌定植妇女妊娠结局的影响，以及不同生殖器微生物定植妇女妊娠期性交与早产之间的关系，B族链球菌定植对妊娠结局的影响，细菌性阴道病与妊娠结局之间的关系，红霉素治疗对沙眼衣原体定植妇女妊娠结局的影响，以及生殖器植物群的种族差异。 在2004年，我们调查了种族和阴道pH值之间的关系（阴道pH值升高与不良妊娠结局相关）。我们发现，在阴道植物群正常的女性中，黑人的pH值比白人略高。然而，我们也注意到，即使在正常范围内，黑人妇女的阴道革兰氏染色评分（表明更多的异常植物群）比他们的白色同行。在革兰氏染色评分的可比值下，黑人和白色女性的pH值没有显著差异。这表明，pH值的差异是由于植物群的差异，而不是一个直接的先天特征。我们还评估了妊娠26周和分娩之间vlora的变化是否与早产有关。获得革兰氏阴性杆菌大肠杆菌和肺炎克雷伯菌与早产风险增加约三倍相关。因为没有其他生物体与早产相关。

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.