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Treatment of bacterial vaginosis before 28 weeks of pregnancy to reduce the incidence of preterm labor
Author(s) -
Rebouças Karinne F.,
Jr. José Eleutério,
Peixoto Raquel C.,
Costa Ana Paula F.,
Cobucci Ricardo N.,
Gonçalves Ana K.
Publication year - 2019
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.12829
Subject(s) - bacterial vaginosis , metronidazole , clindamycin , medicine , incidence (geometry) , odds ratio , pregnancy , confidence interval , obstetrics , meta analysis , gynecology , antibiotics , microbiology and biotechnology , biology , physics , genetics , optics
Background Controversy exists regarding the benefits of treating bacterial vaginosis ( BV ) during pregnancy to reduce the incidence of preterm labor ( PTL ). Objectives To evaluate whether treatment of BV with vaginal clindamycin or oral metronidazole before 28 weeks of pregnancy reduces PTL incidence. Search strategy PubMed, Scopus, Web of Science, Science Direct, CENTRAL , and Sci ELO databases were searched until December 30, 2017. Search terms included “bacterial vaginosis” and “preterm labor.” No language restrictions were applied. Selection criteria Randomized clinical trials that evaluated treatment of BV with clindamycin or metronidazole to reduce PTL incidence. Data collection and analysis The risk of PTL was evaluated by the odds ratio ( OR ) and 95% confidence interval ( CI ). Dichotomous data from each study were combined for meta‐analysis using the Mantel‐Haenszel model. Main results Nine reports were included in the systematic review, with eight reports included in the meta‐analysis. No reduction in the incidence of PTL was found for either metronidazole ( OR 0.94, 95% CI 0.71–1.25) or clindamycin ( OR 1.01, 95% CI 0.75–1.36). Conclusions Use of oral metronidazole or vaginal clindamycin to treat BV before 28 weeks of pregnancy did not reduce the incidence of PTL . PROSPERO registration: CRD 42018086173.