Impact of Metronidazole Therapy on Preterm Birth in Women With Bacterial Vaginosis Flora (Gardnerella vaginalis)

McDonald, Helen; O’Loughlin, John; Vigneswaran, R.; Jolley, P. T.; Harvey, J. A.; Bof, A.; McDonald, Peter J.

doi:10.1097/00006254-199806000-00001

Cited by 4 publications

(4 citation statements)

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“…Randomized clinical trials (RCTs) of antibiotic administration to reduce the rate of pre‐term birth have yielded conflicting results (Morales et al 1994, Hauth et al 1995, McDonald et al 1997, Carey et al 2000, Paavonen et al 2000, Rosenstein et al 2000, Kekki et al 2001, Lamont 2003, Ugwumadu et al 2003) and there is no uniform proof that antibiotic use reduces risk of pre‐term birth. The reader is referred to the original trials and systematic reviews for details (Brocklehurst et al 2000, Guise et al 2001, Klebanoff et al 2003, Leitich et al 2003b).…”

Section: Overview Of Adverse Pregnancy Outcome and Pre‐term Birthmentioning

confidence: 99%

A critical assessment of adverse pregnancy outcome and periodontal disease

Wimmer

Pihlstrom

2008

J Clinic Periodontology

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Variability among studies in definitions of periodontal disease and adverse pregnancy outcomes as well as widespread inadequate control for confounding factors and possible effect modification make it difficult to base meaningful conclusions on published data. However, while there are indications of an association between periodontal disease and increased risk of adverse pregnancy outcome in some populations, there is no conclusive evidence that treating periodontal disease improves birth outcome. Based on a critical qualitative review, available evidence from clinical trials indicates that, although non-surgical mechanical periodontal treatment in the second trimester of pregnancy is safe and effective in reducing signs of maternal periodontal disease, it does not reduce the rate of pre-term birth. Clinical trials currently underway will further clarify the potential role of periodontal therapy in preventing adverse birth outcomes. Regardless of the outcomes of these trials, it is recommended that large, prospective cohort studies be conducted to assess risk for adverse pregnancy outcome in populations with periodontal disease. It is critical that periodontal exposure and adverse birth outcomes be clearly defined and the many potential confounding factors and possible effect modifiers for adverse pregnancy outcome be controlled in these studies. If periodontal disease is associated with higher risk of adverse pregnancy outcome in these specific populations, large multicenter randomized-controlled trials will be needed to determine if prevention or treatment of periodontal disease, perhaps combined with other interventions, has an effect on adverse pregnancy outcome in these women.

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Section: Overview Of Adverse Pregnancy Outcome and Pre‐term Birthmentioning

confidence: 99%

A critical assessment of adverse pregnancy outcome and periodontal disease

Wimmer

Pihlstrom

2008

J Clinic Periodontology

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show abstract

“…There is convincing evidence linking PTB with infections, especially genitourinary infections, which appear to be an important factor in the premature rupture of the membranes (Romero & Mazor 1988, Gibbs et al 1992). However, studies linking treatment of bacterial vaginosis and PTB have failed to yield definite conclusions on the efficacy of treatment‐related reduction of PTB (Morales et al 1994, Hauth et al 1995, McDonald et al 1997, Carey et al 2000). Women with pre‐term labour do not invariably present with a positive amniotic fluid culture (Romero et al 1988, Boggess 2005), suggesting that subclinical infections, resulting in translocation of bacteria, bacterial metabolites, and lipopolysaccharides (LPS), may account for some of the inflammatory processes associated with PTB.…”

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confidence: 99%