Risk factors for prematurity and premature rupture of membranes: A prospective study of the vaginal flora in pregnancy |
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Authors: | Howard Minkoff Amos N. Grunebaum Richard H. Schwarz Joseph Feldman Marinella Cummings William Crombleholme Lorraine Clark George Pringle William M. McCormack |
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Affiliation: | 1. Department of Obstetrics and Gynecology, State University of New York, Downstate Medical Center Brooklyn, New York, USA;2. Department of Medicine, State University of New York, Downstate Medical Center Brooklyn, New York, USA;3. Department of Pathology, State University of New York, Downstate Medical Center Brooklyn, New York, USA;4. Department of Preventive Medicine, State University of New York, Downstate Medical Center Brooklyn, New York, USA |
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Abstract: | Prematurity remains a major cause of perinatal mortality in the United States. Some research has indicated that infectious agents play a role in either initiating preterm labor, causing premature rupture of the membranes, or preventing tocolysis. This study attempted to determine if the presence of various vaginal pathogens in early pregnancy was associated with the subsequent development of premature rupture of membranes or preterm labor. We found that among 233 evaluable patients those with Trichomonas vaninalis were significantly more likely to have premature rupture of the membranes (p < 0.03), and those with Bacteroides sp. were more likely to be delivered of their infants before 37 weeks (p < 0.03) and to have infants weighing less than 2500 gm (p < 0.05). Those with Ureaplasma urealyticum more frequently began preterm labor (p < 0.05). Preterm premature rupture of the membranes was found significantly more often among patients with Bacteroides sp. Stepwise multiple logistic regression analysis indicated that those associations were not related to the number of previous abortions, deliveries, or preterm deliveries or to maternal age. We conclude that microbiologic screening in early pregnancy may aid in the assessment of patient risk for preterm delivery. |
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Keywords: | Reprint requests: Howard Minkoff M.D. Department of Obstetrics and Gynecology Downstate Medical Center Box #24 Brooklyn NY 11203. |
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