Date of Award
Spring 2022
Degree Name
Master of Medical Science (Physician Assistant)
Department
Physician Assistant; College of Health Sciences
First Advisor
Lisa Akselrad
Abstract
Abstract
Background: Bacterial Vaginosis (BV) is a common genital tract infection in women, and in pregnant women, has been linked to adverse birth outcomes such as premature delivery and low-birth-weight infants. The treatment of BV is either Metronidazole or Clindamycin, both of which are safe during pregnancy. Currently, there are no current guidelines for screening asymptomatic women for BV while pregnant. This paper aims to analyze current literature to determine if screening asymptomatic pregnant women will reduce the outcome of preterm and low-birth-weight infants.
Methods: A literature search was completed using search terms such as “bacterial vaginosis AND screening AND pregnancy”, “bacterial vaginosis AND preterm”, “bacterial vaginosis AND pregnancy”, and “bacterial vaginosis AND preterm delivery AND treatment”. Search engines used included PubMed, CDC, AccessMedicine, and Google Scholar.
Results: The study by Kiss, Petricevic and Husslein found 50% reduction in low-birth-weight infants in the intervention group vs the control group. Hauth et al. found that within women positive for BV, preterm delivery rates were 31% in the intervention group and 49% in the control group. Hillier et al. found that women with BV were at a 40% increased risk of preterm delivery compared to women without BV, and furthermore found that women who were treated for BV had the same risk of preterm delivery as women without BV. Meta-analysis done by Leitich and Kiss found screening for BV in early pregnancy (before 15 weeks gestation) is not associated with increased risk of preterm delivery. Subtil et al.. did not find a significant reduction in preterm birth in the intervention group of BV positive pregnant women who were treated compared to the placebo. Carey et al.. also did not find a statistically significant reduction in preterm births in pregnant women with BV who received treatment compared to pregnant women with BV who did not receive treatment. The study by Afolabi, Moses and Oduyebo treated all pregnant women found to have BV, and yet treated BV infection was still associated with 2.7 times increased risk of preterm delivery compared to the general population.
Conclusion: After a thorough literature analysis, there was insufficient evidence to support that screening and subsequent treatment of asymptomatic pregnant women with BVwill reduce the adverse outcomes of low-birth-weight and preterm delivery. This finding supports the current USPSTF recommendation against screening of asymptomatic pregnant women for BV.
Recommended Citation
Greiner, Lauren, "Will screening women for bacterial vaginosis in pregnancy reduce the adverse outcomes of bacterial vaginosis infection in pregnancy, such as preterm delivery or low-birth-weight infants?" (2022). Capstone Showcase. 3.
https://scholarworks.arcadia.edu/showcase/2022/pa/3
Will screening women for bacterial vaginosis in pregnancy reduce the adverse outcomes of bacterial vaginosis infection in pregnancy, such as preterm delivery or low-birth-weight infants?
Abstract
Background: Bacterial Vaginosis (BV) is a common genital tract infection in women, and in pregnant women, has been linked to adverse birth outcomes such as premature delivery and low-birth-weight infants. The treatment of BV is either Metronidazole or Clindamycin, both of which are safe during pregnancy. Currently, there are no current guidelines for screening asymptomatic women for BV while pregnant. This paper aims to analyze current literature to determine if screening asymptomatic pregnant women will reduce the outcome of preterm and low-birth-weight infants.
Methods: A literature search was completed using search terms such as “bacterial vaginosis AND screening AND pregnancy”, “bacterial vaginosis AND preterm”, “bacterial vaginosis AND pregnancy”, and “bacterial vaginosis AND preterm delivery AND treatment”. Search engines used included PubMed, CDC, AccessMedicine, and Google Scholar.
Results: The study by Kiss, Petricevic and Husslein found 50% reduction in low-birth-weight infants in the intervention group vs the control group. Hauth et al. found that within women positive for BV, preterm delivery rates were 31% in the intervention group and 49% in the control group. Hillier et al. found that women with BV were at a 40% increased risk of preterm delivery compared to women without BV, and furthermore found that women who were treated for BV had the same risk of preterm delivery as women without BV. Meta-analysis done by Leitich and Kiss found screening for BV in early pregnancy (before 15 weeks gestation) is not associated with increased risk of preterm delivery. Subtil et al.. did not find a significant reduction in preterm birth in the intervention group of BV positive pregnant women who were treated compared to the placebo. Carey et al.. also did not find a statistically significant reduction in preterm births in pregnant women with BV who received treatment compared to pregnant women with BV who did not receive treatment. The study by Afolabi, Moses and Oduyebo treated all pregnant women found to have BV, and yet treated BV infection was still associated with 2.7 times increased risk of preterm delivery compared to the general population.
Conclusion: After a thorough literature analysis, there was insufficient evidence to support that screening and subsequent treatment of asymptomatic pregnant women with BVwill reduce the adverse outcomes of low-birth-weight and preterm delivery. This finding supports the current USPSTF recommendation against screening of asymptomatic pregnant women for BV.