Screening for bacterial vaginosis in pregnancy.

摘要: Context Bacterial vaginosis (BV) is a strong independent risk factor for adverse pregnancy outcomes. BV found in 9% to 23% of pregnant women. Symptoms include vaginal discharge, pruritus, or malodor, but often women with are asymptomatic. Objectives To determine whether screening and treating reduces outcomes, as part an assessment the U.S. Preventive Services Task Force. Data sources Randomized clinical trials treatment that measured outcomes were identified from multiple searches MEDLINE 1966 1999, Cochrane Controlled Trials Register Library, national experts. Study selection All randomized controlled specifically extraction The following information was abstracted: study design blinding, diagnostic methods, antibiotic interventions, timing pregnancy, criteria treatment, comorbidities, demographic details, factors preterm delivery such previous delivery, compliance, rates spontaneous total less than 37 weeks 34 weeks, premature rupture membranes, low birth weight 2500 grams, abortion, postpartum endometritis, neonatal sepsis. For each study, we effect by calculating difference rate given outcome control group minus (the absolute reduction [ARR]). A stepwise procedure based on profile likelihood applied assess heterogeneity, pool studies when appropriate, calculate mean 90% confidence intervals (CIs) treatment. synthesis Seven met inclusion meta-analysis. We no benefit average-risk any outcome. Results high-risk populations, statistically heterogeneous. They clustered into two groups; one showed (ARR=-0.08, CI=-0.19 0.04), whereas three homogeneous potential (pooled ARR=0.22; CI=0.13 0.31) before weeks. Four reported results pooled estimate (ARR=0.04; CI=-0.02 0.09), variation noted among individual studies. Two increase who did not have received Comparisons patient regimens, designs explain heterogeneity Conclusions routine subgroup may treatment; however, there be whom could occurrence delivery.