Association between Bacterial Vaginosis and Preterm Delivery of a Low-Birth-Weight Infant
Open accessAbstract
BACKGROUND: Bacterial vaginosis is believed to be a risk factor for preterm delivery. We undertook a study of the association between bacterial vaginosis and the preterm delivery of infants with low birth weight after accounting for other known risk factors. METHODS: In this cohort study, we enrolled 10,397 pregnant women from seven medical centers who had no known medical risk factors for preterm delivery. At 23 to 26 weeks' gestation, bacterial vaginosis was determined to be present or absent on the basis of the vaginal pH and the results of Gram's staining. The principal outcome variable was the delivery at less than 37 weeks' gestation of an infant with a birth weight below 2500 g. RESULTS: Bacterial vaginosis was detected in 16 percent of the 10,397 women. The women with bacterial vaginosis were more likely to be unmarried, to be black, to have low incomes, and to have previously delivered low-birth-weight infants. In a multivariate analysis, the presence of bacterial vaginosis was related to preterm delivery of a low-birth-weight infant (odds ratio, 1.4; 95 percent confidence interval, 1.1 to 1.8). Other risk factors that were significantly associated with such a delivery in this population were the previous delivery of a low-birth-weight infant (odds ratio, 6.2; 95 percent confidence interval, 4.6 to 8.4), the loss of an earlier pregnancy (odds ratio, 1.7; 1.3 to 2.2), primigravidity (odds ratio, 1.6; 1.1 to 1.9), smoking (odds ratio, 1.4; 1.1 to 1.7); and black race (odds ratio, 1.4; 1.1 to 1.7). Among women with bacterial vaginosis, the highest risk of preterm delivery of a low-birth-weight infant was found among those with both vaginal bacteroides and Mycoplasma hominis (odds ratio, 2.1; 95 percent confidence interval, 1.5 to 3.0). CONCLUSIONS: Bacterial vaginosis was associated with the preterm delivery of low-birth-weight infants independently of other recognized risk factors.
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Bacterial vaginosis is associated with a 1.5-fold to 3-fold increase in the rate of preterm birth.
“A score of 7–10 is used to diagnose bacterial vaginosis, and has been associated with a 1·5-fold to 3-fold increase in the rate of preterm birth.97, 98”
From Epidemiology and causes of preterm birth (2008) · cites this paper as [98]
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- Authors
- Hillier, S. L., Nugent, R. P., Eschenbach, D. A., Krohn, M. A., Gibbs, R. S., Martin, D. H., Cotch, M. F., Edelman, R., Pastorek, J. G., Rao, A. V., McNellis, D., Regan, J. A., Carey, J. C., & Klebanoff, M. A.
- Affiliations
- University of Washington (US)
- National Institutes of Health (US)
- Louisiana State University (US)
- National Institute of Allergy and Infectious Diseases (US)
- RTI International (US)
- Columbia University (US)
- ORCID
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 1995-12-28
- Volume
- 333
- Issue
- 26
- Pages
- 1737-1742
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2317894502
- Cited by
- 1,492
- References
- 25
- Citations by year
- 2026: 26 · 2025: 26 · 2024: 34 · 2023: 41 · 2022: 34 · 2021: 56 · 2020: 40 · 2019: 46 · 2018: 46 · 2017: 50 · 2016: 57 · 2015: 49 · 2014: 64 · 2013: 48 · 2012: 53
- FWCI
- 28.50
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (Z99 EY999999)
- National Institute of Allergy and Infectious Diseases (AI 42532)
- National Institute of Child Health and Human Development
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (HD-3-2836, HD3-2832)
- Topics
- Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
- Health Sciences › Medicine › Epidemiology › Preterm Birth and Chorioamnionitis
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Neonatal and Maternal Infections
- Keywords
- bacterial vaginosis, preterm birth, low birth weight, pregnancy, risk factors, Mycoplasma hominis, Bacteroides, smoking, primigravida, racial differences, socioeconomic factors
- MeSH terms
- Female, Humans, Infant, Low Birth Weight, Infant, Newborn, Infant, Premature, Obstetric Labor, Premature, Pregnancy, Pregnancy Complications, Infectious, Pregnancy Outcome, Risk Factors, Socioeconomic Factors, Cohort Studies, Logistic Models, Vaginosis, Bacterial
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