Risk factors for preterm premature rupture of fetal membranes: a multicenter case-control study

Article Abstract:

Premature delivery is associated with a poor pregnancy outcome. Premature rupture of the membranes surrounding the fetus (PROM) is a major cause of premature labor and delivery. Infants who are born early risk complications associated with low birth weight. Many risk factors for PROM have been identified. In an effort to obtain detailed information that can be used to develop prevention strategies, 41 potential risk factors associated with PROM were studied. A comprehensive questionnaire was given to 341 women with PROM and 253 similarly-matched women without PROM attending six different health centers in the US. Questions were classified by categories that included demographic information, medical history, gynecological history, obstetric history information regarding the current pregnancy and sexual behavior. Eleven significant risk factors emerged from the study. Women who experienced bleeding in more than one trimester were 7.4 times more likely to have PROM. A preterm delivery of a previous pregnancy was associated with a 2.5 times greater risk of PROM. Women who smoked cigarettes during pregnancy were 2.1 times more likely to have PROM, but if the women smoked but then stopped, the odds were reduced to 1.58. The relationship between vaginal bleeding and PROM requires further investigation. Women should be encouraged to stop smoking during pregnancy to avoid the chances of PROM. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Physiological aspects, Premature labor, Tobacco, Smoking and women, Women smokers

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A randomized placebo-controlled trial of erythromycin for the treatment of Ureaplasma urealyticum to prevent premature delivery

Article Abstract:

Genital infections during pregnancy have been associated with prematurity and low birth weight. However, the association between infections with organisms such as Ureaplasma urealyticum and poor pregnancy outcome has not been consistent. In some studies, antibiotic treatment of women infected with U. urealyticum or other bacteria resulted in fewer premature infants, while other studies suggested that prematurity and U. urealyticum infection are not associated. As part of a large study, the effects of the antibiotic erythromycin or placebo on the pregnancy outcomes of 1,181 women were evaluated. This study differed from others in that women with infections in addition to U. urealyticum were excluded. The subjects received treatment beginning between 26 and 30 weeks gestation to term, three times daily. Erythromycin treatment did not eliminate the organism from subjects' lower genital tracts, and no effect on pregnancy outcome was found. (Consumer Summary produced by Reliance Medical Information, Inc.)

Pregnancy, Complications of, Pregnancy complications, Ureaplasma urealyticum, Bacterial vaginitis

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Use of antibiotics to prevent preterm birth

Article Abstract:

Antibiotic treatment may be appropriate for pregnant women with selected infections in order to prolong pregnancy in these at-risk mothers. Research indicates that selectively treated infections should include those caused by Chlamydia trachomatis, Trichomonas vaginalis and Neisseria gonorrhoeae, as well as bacterial vaginosis and bacteriuria. Standard preventive treatment should be given to women infected with group B streptococcus. Few infected pregnant patients have reported significant side effects from antibiotic treatment.

Health aspects, Care and treatment, Antibiotics, Prevention, Premature birth

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