Rate of preterm births in pregnant women with common lower genital tract infection: a population-based study based on the clinical practice

Abstract

Objective. To estimate the rate of preterm births in pregnant women with lower genital tract infection, i.e. vulvovaginitis-bacterial vaginosis and to check their prevention by drug treatments in the usual clinical practice.

Method. The rate of preterm birth of pregnant women with or without lower genital tract infection was evaluated in the population-based large data set of the Hungarian Case–Control Surveillance of Congenital Abnormalities. Only prospectively and medically recorded diagnoses of vulvovaginitis-bacterial vaginosis were evaluated.

Results. Of 38,151 newborn infants, 2698 (7.1%) had mothers with vulvovaginitis-bacterial vaginosis diagnosed in early pregnancy and the rate of preterm births was 7.5% among them, while this figure was 9.3% in babies born to mothers without these recognized genital infections. After early diagnosis and treatment of vulvovaginitis-bacterial vaginosis, clotrimazole and ampicillin seemed to be most effective to reduce the preterm birth during the study period. However, the rate of preterm births was lower in babies born to mothers without recorded vulvovaginitis-bacterial vaginosis but treated by clotrimazole and ampicillin (7.2–7.8%) as well.

Conclusion. The lower rate of preterm births in babies born to mothers with vulvovaginitis-bacterial vaginosis may be explained by their effective treatment. However, the high rate of preterm births in pregnant women without genital tract infection and antimicrobial treatment may be connected with asymptomatic or unrecognized symptomatic and untreated vaginal infections.

Keywords:

• Lower genital tract infection
• vulvovaginitis-bacterial vaginosis
• pregnancy
• preterm birth
• antimicrobial treatment