Abstract
Controversy exists regarding the benefits of treating bacterial vaginosis (BV) during pregnancy to reduce the incidence of preterm labor (PTL). To evaluate whether treatment of BV with vaginal clindamycin or oral metronidazole before 28weeks of pregnancy reduces PTL incidence. PubMed, Scopus, Web of Science, Science Direct, CENTRAL, and SciELO databases were searched until December 30, 2017. Search terms included "bacterial vaginosis" and "preterm labor." No language restrictions were applied. Randomized clinical trials that evaluated treatment of BV with clindamycin or metronidazole to reduce PTL incidence. 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. 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). Use of oral metronidazole or vaginal clindamycin to treat BV before 28weeks of pregnancy did not reduce the incidence of PTL. PROSPERO registration: CRD42018086173.
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