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Infection and preterm delivery

BMJ 1999; 318 doi: (Published 27 February 1999) Cite this as: BMJ 1999;318:548

There is not yet enough evidence that antibiotics help

  1. Peter Brocklehurst, Clinical epidemiologist.
  1. National Perinatal Epidemiology Unit, Radcliffe Infirmary, Oxford OX2 6HE

    Preterm delivery is defined as delivery before the 37th completed week of pregnancy, and in 1996in Scotland 84% of neonatal deaths of normally formed infants were associated with preterm delivery.1 The aetiology of preterm delivery is poorly understood, though recent evidence suggests that infection may be implicated in a substantial proportion of cases.2 The part that infection plays in the development of preterm labour or preterm, pre-labour rupture of membranes leading to preterm delivery has been the focus of much research in recent years.

    One element of this work has been the finding of a strong association between the presence of bacterial vaginosis and preterm delivery. Bacterial vaginosis is a common infection of the female genital tract, caused by heavy concentrations of a mixed group of organisms, including Gardnerella vaginalis, Mycoplasma hominis, and anaerobes including curved rods and Mobiluncus species. Many of these organisms are present in small numbers in the vagina normally. Symptomatic infection is characterised by a grey vaginal discharge with a …

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