Impact Of Treatment For Bacterial Vaginosis On Prematurity Among Brazilian Pregnant Women: A Retrospective Cohort Study.

Bacterial vaginosis has been associated with prematurity and other perinatal complications. However, the efficacy of the treatment for preventing such complications has not yet been well established. The objective of this study was to evaluate the impact of treatment for bacterial vaginosis on a low-risk population of Brazilian pregnant women, in order to prevent prematurity and other perinatal complications. Observational retrospective cohort study, at the Obstetric and Gynecology Department, Universidade Estadual de Campinas (Unicamp). Vaginal bacterioscopy results from 785 low-risk pregnant women were studied. Three different groups of women were identified: 580 without bacterial vaginosis during pregnancy, 134 with bacterial vaginosis treated using imidazoles (metronidazole, tinidazole, or secnidazole) during pregnancy, and 71 with bacterial vaginosis not treated during pregnancy. The diagnosis of bacterial vaginosis was based on Nugent's criteria, from the vaginal bacterioscopy performed during the first prenatal care visit. The frequency of prematurity was 5.5% among the women without bacterial vaginosis, 22.5% among those with untreated bacterial vaginosis and 3.7% among those with treated bacterial vaginosis. The risk ratios for perinatal complications were significantly higher in the group with untreated bacterial vaginosis: premature rupture of membranes, 7.5 (95% CI: 1.9-34.9); preterm labor, 3.4 (95% CI: 1.4-8.1); preterm birth, 6.0 (95% CI: 1.9-19.7); and low birth weight, 4.2 (95% CI: 1.2-14.3). The treatment of bacterial vaginosis significantly reduced the rates of prematurity and other perinatal complications among these low-risk Brazilian pregnant women, regardless of the history of previous preterm delivery.123108-1

Impacto do tratamento da vaginose bacteriana sobre a prematuridade em grávidas brasileiras: um estudo tipo coorte retrospectivo

CONTEXT AND OBJECTIVE: Bacterial vaginosis has been associated with prematurity and other perinatal complications. However, the efficacy of the treatment for preventing such complications has not yet been well established. The objective of this study was to evaluate the impact of treatment for bacterial vaginosis on a low-risk population of Brazilian pregnant women, in order to prevent prematurity and other perinatal complications. DESIGN AND SETTING: Observational retrospective cohort study, at the Obstetric and Gynecology Department, Universidade Estadual de Campinas (Unicamp). METHODS: Vaginal bacterioscopy results from 785 low-risk pregnant women were studied. Three different groups of women were identified: 580 without bacterial vaginosis during pregnancy, 134 with bacterial vaginosis treated using imidazoles (metronidazole, tinidazole, or secnidazole) during pregnancy, and 71 with bacterial vaginosis not treated during pregnancy. The diagnosis of bacterial vaginosis was based on Nugent's criteria, from the vaginal bacterioscopy performed during the first prenatal care visit. RESULTS: The frequency of prematurity was 5.5% among the women without bacterial vaginosis, 22.5% among those with untreated bacterial vaginosis and 3.7% among those with treated bacterial vaginosis. The risk ratios for perinatal complications were significantly higher in the group with untreated bacterial vaginosis: premature rupture of membranes, 7.5 (95% CI: 1.9-34.9); preterm labor, 3.4 (95% CI: 1.4-8.1); preterm birth, 6.0 (95% CI: 1.9-19.7); and low birth weight, 4.2 (95% CI: 1.2-14.3). CONCLUSION: The treatment of bacterial vaginosis significantly reduced the rates of prematurity and other perinatal complications among these low-risk Brazilian pregnant women, regardless of the history of previous preterm delivery.CONTEXTO E OBJETIVO: A vaginose bacteriana vem sendo apontada como fator de risco para prematuridade e outras complicações perinatais. Entretanto, a eficácia do seu tratamento na prevenção destas complicações ainda não está esclarecida. O objetivo deste estudo foi avaliar o impacto do tratamento da vaginose bacteriana durante o pré-natal de baixo risco para a prevenção de prematuridade e outras complicações perinatais. TIPO DE ESTUDO E LOCAL: Coorte retrospectivo observacional, no Departamento de Tocoginecologia, Universidade Estadual de Campinas (Unicamp). MÉTODOS: Foram estudadas 785 gestantes de baixo risco com resultado da bacterioscopia de secreção vaginal. Foram identificados três grupos de mulheres: 580 sem vaginose bacteriana durante a gestação, 134 com vaginose bacteriana tratada com imidazólicos (metronidazol, tinidazol, ou secnidazol) durante a gestação, e 71 com vaginose bacteriana não tratada durante a gestação. O diagnóstico de vaginose bacteriana foi realizado utilizando os critérios de Nugent na bacterioscopia vaginal da primeira consulta. RESULTADOS: O parto prematuro ocorreu em 5,5% do grupo de mulheres sem vaginose bacteriana, 22,5% do grupo com vaginose bacteriana não tratada, e 3,7% do grupo com vaginose bacteriana tratada. A razão de risco para as complicações perinatais no grupo com vaginose bacteriana não tratada durante a gestação foi: 7,5 (intervalo de confiança, IC, de 95%: 1,9-34,9) para rotura prematura de membranas no pré-termo, 3,4 (IC de 95%: 1,4-8,1) para trabalho de parto prematuro, 6,0 (IC de 95%: 1,9-19,7) para parto prematuro e 4,2 (IC de 95%: 1,2-14,3) para baixo peso ao nascer. CONCLUSÃO: O tratamento da vaginose bacteriana reduziu significativamente os índices de prematuridade e outras complicações perinatais entre as gestantes de baixo risco, independentemente da história prévia de parto prematuro.10811

Impact of treatment for bacterial vaginosis on prematurity among Brazilian pregnant women: a retrospective cohort study

CONTEXT AND OBJECTIVE: Bacterial vaginosis has been associated with prematurity and other perinatal complications. However, the efficacy of the treatment for preventing such complications has not yet been well established. The objective of this study was to evaluate the impact of treatment for bacterial vaginosis on a low-risk population of Brazilian pregnant women, in order to prevent prematurity and other perinatal complications. DESIGN AND SETTING: Observational retrospective cohort study, at the Obstetric and Gynecology Department, Universidade Estadual de Campinas (Unicamp). METHODS: Vaginal bacterioscopy results from 785 low-risk pregnant women were studied. Three different groups of women were identified: 580 without bacterial vaginosis during pregnancy, 134 with bacterial vaginosis treated using imidazoles (metronidazole, tinidazole, or secnidazole) during pregnancy, and 71 with bacterial vaginosis not treated during pregnancy. The diagnosis of bacterial vaginosis was based on Nugent's criteria, from the vaginal bacterioscopy performed during the first prenatal care visit. RESULTS: The frequency of prematurity was 5.5% among the women without bacterial vaginosis, 22.5% among those with untreated bacterial vaginosis and 3.7% among those with treated bacterial vaginosis. The risk ratios for perinatal complications were significantly higher in the group with untreated bacterial vaginosis: premature rupture of membranes, 7.5 (95% CI: 1.9-34.9); preterm labor, 3.4 (95% CI: 1.4-8.1); preterm birth, 6.0 (95% CI: 1.9-19.7); and low birth weight, 4.2 (95% CI: 1.2-14.3). CONCLUSION: The treatment of bacterial vaginosis significantly reduced the rates of prematurity and other perinatal complications among these low-risk Brazilian pregnant women, regardless of the history of previous preterm delivery