Routine screening of abnormal vaginal flora during pregnancy reduces the odds of preterm birth: a systematic review and meta-analysis
Abstract Prematurity is the leading cause of perinatal mortality and the morbidity among children under the age of 5. The prevalence of preterm birth is between 5 and 18% worldwide. Approximately 30% of preterm deliveries occur as a consequence of fetal or maternal infections. Bacterial vaginosis ca...
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2023-08-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-023-40993-x |
| _version_ | 1797576783571189760 |
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| author | Eszter Hoffmann Szilárd Váncsa Alex Váradi Péter Hegyi Rita Nagy Balázs Hamar Vanda Futács Begüm Kepkep Péter Nyirády Csaba Demendi Nándor Ács |
| author_facet | Eszter Hoffmann Szilárd Váncsa Alex Váradi Péter Hegyi Rita Nagy Balázs Hamar Vanda Futács Begüm Kepkep Péter Nyirády Csaba Demendi Nándor Ács |
| author_sort | Eszter Hoffmann |
| collection | DOAJ |
| description | Abstract Prematurity is the leading cause of perinatal mortality and the morbidity among children under the age of 5. The prevalence of preterm birth is between 5 and 18% worldwide. Approximately 30% of preterm deliveries occur as a consequence of fetal or maternal infections. Bacterial vaginosis can increase the risk of ascending infections. However, there is no recommendation or protocol for screening of abnormal vaginal flora. The aim of this systematic review was to investigate the effectiveness of routine screening of abnormal vaginal flora during pregnancy care. We conducted our systematic search in the following databases: MEDLINE via PubMed, Embase, and Cochrane Library. Studies reporting on pregnant women with no symptoms of bacterial vaginosis were included in our analysis if they provided data on the outcome of their pregnancy. The intervention group went through screening of abnormal vaginal flora in addition to routine pregnancy care. Odds ratio (OR) with 95% confidence intervals (CIs) was used as effect size measure. From each study the total number of patients and number of events was extracted in both the intervention and control arm to calculate OR. Altogether we included 13 trials with 143,534 patients. The screening methods were Gram stain, pH screening, pH self-screening and pH screening combined with Gram stain. Regular screening of vaginal flora compared to no screening significantly reduces the odds of preterm birth before 37 weeks (8.98% vs 9.42%; OR 0.71, CI 0.57–0.87), birthweight under 2500 g (6.53% vs 7.24%; OR 0.64, CI 0.50–0.81), preterm birth before 32 weeks (1.35% vs 2.03%; OR 0.51, CI 0.31–0.85) and birthweight under 1000 g (0.86% vs 2.2%; OR 0.33, CI 0.19–0.57). In conclusion, the routine screening of abnormal vaginal flora might prevent preterm birth, extreme preterm birth, low birthweight deliveries and very low birthweight deliveries. Further research is needed to assess the problem more accurately. |
| first_indexed | 2024-03-10T21:58:40Z |
| format | Article |
| id | doaj.art-94eef86ad9cc4a2dad40ebf04d941df8 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-03-10T21:58:40Z |
| publishDate | 2023-08-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-94eef86ad9cc4a2dad40ebf04d941df82023-11-19T13:02:55ZengNature PortfolioScientific Reports2045-23222023-08-0113111010.1038/s41598-023-40993-xRoutine screening of abnormal vaginal flora during pregnancy reduces the odds of preterm birth: a systematic review and meta-analysisEszter Hoffmann0Szilárd Váncsa1Alex Váradi2Péter Hegyi3Rita Nagy4Balázs Hamar5Vanda Futács6Begüm Kepkep7Péter Nyirády8Csaba Demendi9Nándor Ács10Department of Obstetrics and Gynecology, Semmelweis UniversityCentre for Translational Medicine, Semmelweis UniversityInstitute for Translational Medicine, Medical School, University of PécsCentre for Translational Medicine, Semmelweis UniversityCentre for Translational Medicine, Semmelweis UniversityDepartment of Obstetrics and Gynecology, Semmelweis UniversityDepartment of Obstetrics and Gynecology, Semmelweis UniversityDepartment of Obstetrics and Gynecology, Semmelweis UniversityCentre for Translational Medicine, Semmelweis UniversityDepartment of Obstetrics and Gynecology, Semmelweis UniversityDepartment of Obstetrics and Gynecology, Semmelweis UniversityAbstract Prematurity is the leading cause of perinatal mortality and the morbidity among children under the age of 5. The prevalence of preterm birth is between 5 and 18% worldwide. Approximately 30% of preterm deliveries occur as a consequence of fetal or maternal infections. Bacterial vaginosis can increase the risk of ascending infections. However, there is no recommendation or protocol for screening of abnormal vaginal flora. The aim of this systematic review was to investigate the effectiveness of routine screening of abnormal vaginal flora during pregnancy care. We conducted our systematic search in the following databases: MEDLINE via PubMed, Embase, and Cochrane Library. Studies reporting on pregnant women with no symptoms of bacterial vaginosis were included in our analysis if they provided data on the outcome of their pregnancy. The intervention group went through screening of abnormal vaginal flora in addition to routine pregnancy care. Odds ratio (OR) with 95% confidence intervals (CIs) was used as effect size measure. From each study the total number of patients and number of events was extracted in both the intervention and control arm to calculate OR. Altogether we included 13 trials with 143,534 patients. The screening methods were Gram stain, pH screening, pH self-screening and pH screening combined with Gram stain. Regular screening of vaginal flora compared to no screening significantly reduces the odds of preterm birth before 37 weeks (8.98% vs 9.42%; OR 0.71, CI 0.57–0.87), birthweight under 2500 g (6.53% vs 7.24%; OR 0.64, CI 0.50–0.81), preterm birth before 32 weeks (1.35% vs 2.03%; OR 0.51, CI 0.31–0.85) and birthweight under 1000 g (0.86% vs 2.2%; OR 0.33, CI 0.19–0.57). In conclusion, the routine screening of abnormal vaginal flora might prevent preterm birth, extreme preterm birth, low birthweight deliveries and very low birthweight deliveries. Further research is needed to assess the problem more accurately.https://doi.org/10.1038/s41598-023-40993-x |
| spellingShingle | Eszter Hoffmann Szilárd Váncsa Alex Váradi Péter Hegyi Rita Nagy Balázs Hamar Vanda Futács Begüm Kepkep Péter Nyirády Csaba Demendi Nándor Ács Routine screening of abnormal vaginal flora during pregnancy reduces the odds of preterm birth: a systematic review and meta-analysis Scientific Reports |
| title | Routine screening of abnormal vaginal flora during pregnancy reduces the odds of preterm birth: a systematic review and meta-analysis |
| title_full | Routine screening of abnormal vaginal flora during pregnancy reduces the odds of preterm birth: a systematic review and meta-analysis |
| title_fullStr | Routine screening of abnormal vaginal flora during pregnancy reduces the odds of preterm birth: a systematic review and meta-analysis |
| title_full_unstemmed | Routine screening of abnormal vaginal flora during pregnancy reduces the odds of preterm birth: a systematic review and meta-analysis |
| title_short | Routine screening of abnormal vaginal flora during pregnancy reduces the odds of preterm birth: a systematic review and meta-analysis |
| title_sort | routine screening of abnormal vaginal flora during pregnancy reduces the odds of preterm birth a systematic review and meta analysis |
| url | https://doi.org/10.1038/s41598-023-40993-x |
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