Abstract
Preterm labour is the onset of labour between ≥ 24 weeks to < 37 weeks of gestation. Bacterial Vaginosis (BV) is a polymicrobial condition with predominant lactobacilli in the vaginal flora. It is an important risk factor for preterm labour with an incidence of 5-18% of all deliveries causing increased perinatal morbidity and mortality with subsequent neurodevelopmental problems as cerebral palsy. We aimed to determine the association of BV with preterm labour population. A case control study was conducted comparing the prevalence of bacterial vaginosis in women having term labour with those who had preterm delivery. Chi square test was used to compare differences in participants’ age, duration of pregnancy and duration of marriage. Odd ratio and CI was calculated for the association between BV and preterm labour. Nearly half of the participants that experienced preterm labour were between 21 and 25 years old (46.7%, <i>n</i> = 35) and nearly half of the participants that experienced term pregnancy were between 21 and 25 years old as well (48.0%, <i>n</i> = 36). Additionally, the majority of participants had been married for three to four years, for those that experienced preterm labour (64.0%, <i>n</i> = 48) and term pregnancy (52.0%, <i>n</i> = 39). Furthermore, nearly half of the participants’ duration of pregnancy was between 33 and 34 weeks (49.3%, <i>n</i> = 37) and 52.0% of participants who experienced term pregnancy had been pregnant for 37 to 38 weeks (<i>n</i> = 39). Women with Bacterial Vaginosis, experienced preterm labour in 26.7% cases (<i>n</i> = 20) as compared to those who had term pregnancy 12.0% (<i>n</i> = 9). BV was significantly associated with preterm labour (OR=7.3, 95% CI =1.9-27.5, P=0.003). There was no significant difference in participants’ age between preterm labour and term pregnancy groups, (p value=0.880). Additionally, there was no significant difference in participants’ duration of marriage between preterm labour and term pregnancy groups, (p value=0.801). Bacterial Vaginosis is a risk factor for preterm labor. The study also concluded that there is no significant association between age, duration of pregnancy and duration of marriage between preterm labour and term pregnancy groups.
Highlights
Preterm labour is the onset of labour between ≥ 24 weeks to < 37 weeks of gestation
Using SPSS 23.0, risk analysis was conducted to determine if bacterial vaginosis was a risk factor for preterm labour
In binary regression Bacterial Vaginosis (BV) was significantly associated with preterm labour (OR=7.3, 95% CI =1.9-27.5, P=0.003) Results of Research Question 2 Null Hypothesis 2 (HO2): There is no significant difference between age, duration of pregnancy and duration of marriage between preterm labour and term pregnancy groups
Summary
Preterm labour is the onset of labour between ≥ 24 weeks to < 37 weeks of gestation. It is determined by uterine contractions with frequency of four per 20 minutes or eight per 60 minutes, accompanied by one of the following: Preterm rupture of membranes (PROM), cervical dilation greater than 2 cm, effacement exceeding 50 percent, or a change in cervical dilation or effacement detected by serial examinations [1]. BV is a polymicrobial infection characterized by replacement of normal vaginal flora which is rich in lactobacilli, with anaerobes. It is confirmed by Amsel’s criteria which includes presence of thin homogenous vaginal discharge, pH above 4.5, positive Whiff’s test and presence of clue cells on microscopy. The etiology of preterm birth is multifactorial but there is well accepted evidence to implicate
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