Abstract
Background: Preterm delivery is one of the most challenging obstetric complication encountered in day to day practice Preterm delivery is the single greatest cause of perinatal mortality and morbidity worldwide
Objective: The aim of this study was to determine the role of infections as a maternal risk factor for preterm labour.
Study Design: It was a case control study in which 230 women who underwent preterm delivery were taken as cases and 230 women as control matching in age who underwent normal term delivery in our obstetric population. The study duration was 1 year from November 2012 to November 2013
Results: A total of 460 patients were studied. Women with history of maternal infections were significantly more in the case group (23.5%) than in the control group (9.6%). Women with vaginal infections were significantly more in the case group(9.1%) than the control group (1.3%). Discharge PV was observed more in the case group (26.5%) than the control group (10.4%) and the difference was significant also Mothers who had history of STD were significantly more in the case group (10%) than in the control group (2.2%) Women with UTI is significantly more in the case group(31.7%) than the control group(15.7%. Women with periodontal problems were significantly more in the case group (5.2%) than the control group (1.3%).
Conclusion: Maternal infection both systemic & local significantly contributed to produce the situation of pre-term labour.
Keywords: Preterm delivery, Periodontal infection, Vaginalinfection, Urinary tract infection.
References
- Salafia, CM., Vogel, CA., Vintzileos, AM., Bantham, KF., Pezzullo, J., &Silerman, L. (1991).Placental pathologic findings in preterm birth. American Journal of Obstetrics and Gynaecology. Vol. 165, No. 4, (Oct 1991), pp. 934-8
- Romero, R., Gotsch, F., Pineles, B., &Kusanovic, JP. (2007). Inflammation in pregnancy: its role in reproductive physiology, obstetrical complications, and fetalinjury. Nutrition Reviews. Vol. 65, No. 12 pt 2, (Dec 2007), pp. 194-202.
- Bejar, R., Curbelo, V., Davis, C., & Gluck, l. (1981). Premature labour. II. Bacterial sources of phospholipase. Obstetrics and Gynaecology. 57, No. 4, (April 1981), pp. 479-82.www.intechopen.comClinical Risk Factors for Preterm Birth 89
- Srinivasan, U., Misra, D., Marazita, ML.,& Foxman, B. (2009). Vaginal and oral microbes,host genotype and preterm birth. Medical Hypotheis. Vol. 73, (June 2009), pp. 963-75.
- Sinham, HN.,Caritis, SN., Krohn, MA., & Hillier, SL. Elevated vaginal pH and neutrophils are associated strongly with early spontaneous preterm birth. American Journal of Obstetrics and Gynaecology. Vol. 189, No. 4, (Oct 2003), pp1150-4.
- Andrews, WW.,Goldenburg, RL., Mercer, B., Iams, J., Meis, P., Moawad, A., Das, A.,Vandorsten, JP., Caritis, SN., Thurnau, G., Miodovnik, M., Roberts, J., &McNellis, D. (2000). The Preterm Prediction Study: association of Secondtrimester genitourinary chlamydia infection with subsequent spontaneous preterm birth. American Journal of Obstetrics and Gynaecology. Vol. 183, No. 3, (Sept2000), pp. 662-8.
- Andrews, WW., Klebanoff, MA., Thom, EA., Hauth, JC., Carey, JC., Meiss, PJ., Caritis, SN.,Leveno, KJ., Wapner, RJ., Varner, MW., Iams, JD., Moawad, A., Miodovnik, M.,Sibai, B., Dombrowski, M., Langer, O., & O’Sullivan, MJ. (2006). Mid-pregnancy genitourinary tract infection with Chlamydia trachomatis: association with subsequent preterm delivery in women with bacterial vaginosis and Trichomonas vaginalis. American Journal of Obstetrics and Gynaecology. Vol. 194, No. 2, (Feb 2006),pp. 493-500.
- Carey J C, Klebanoff M A, Hauth J C. et al Metronidazole to prevent preterm delivery in pregnant women with asymptomatic bacterial vaginosis. N Engl J Med 2000342534–540.540 [PubMed]
- Offenbacher, S., Beck, JD., Jared, HL., Mauriello, SM., Mendoza, LC., Couper, DJ., Stewartificial reproduction theraphy,DD., Murtha, AP., Cochran, DL., Dudley, DJ., Reddy, MS., Geurs, NC., &Hauth,JC. The Maternal Oral Therapy to Reduce Obstetric Risk (MOTOR) Investigators.(2009). Effects of Periodontal Therapy on Rate of Preterm Delivery: A randomized controlled trial. Obstetrics and Gynaecology. Vol. 114, No. 3, (Sep 2009), pp. 551-9.
- Jeffcoat, MK., Geurs, NC., Reddy, MS., Cliver, SP., Goldenberg, RL., &Hauth, JC. (2001).Periodontal infection and preterm birth: results of a prospective study. Journal of the American Dental Association. Vol. 132, No. 7, (Jul 2001), pp. 875-80. www.intechopen.comClinical Risk Factors for Preterm Birth 91
- George, A., Shamim, S., Johnson, M., Ajwani, S., Bhole, S., Blinkhorn, A., Ellis, S., &Andrews, K. (2011). Periodontal treatment during pregnancy and birthoutcomes: ameta-analysis of randomized trials. International Journal of Evidence Based Healthcare.Vol. 9, No. 2, (Jun 2011), pp. 122-47.
Corresponding Author
Dr Shaila S
Professor, Department of Obstetrics and Gynecology, SAT Hospital,
Government Medical College, Thiruvananthapuram, Kerala, India