Cochrane: A genital tract infection during pregnancy can cross into the amniotic fluid and result in prelabour rupture of the membranes and preterm labour. Preterm birth (before 37 weeks of gestation) is associated with poor infant health, death, admission of the newborn to neonatal intensive care in the first few weeks of life, prolonged hospital stay and long-term neurologic disability including cerebral palsy.
In this review, only one study of moderate quality evidence was included. The study reported on 4155 women randomly assigned either to an intervention group (2058 women received infection screening and treatment for bacterial vaginosis, trichomonas vaginalis and candidiasis) or a control group (2097 women received screening, but the results of the screening program were not revealed). The present systematic review found that a simple infection screening and treatment program during routine antenatal care may reduce preterm births and preterm low (below 2500 g) and very low (below 1500 g) birthweight. The simple infection screening reduced preterm births from 5% of women in the control group to 3% in the intervention group. The number of low birthweight preterm infants and very low birthweight preterm infants were significantly lower in the intervention group than in the control group. Moreover, an infection screening and treatment program during routine antenatal care is likely to save over EUR 60,000 for each preterm birth averted.
Authors' conclusions:
There is evidence from one trial that infection screening and treatment programs for pregnant women before 20 weeks' gestation reduce preterm birth and preterm low birthweight. Infection screening and treatment programs are associated with cost savings when used for the prevention of preterm birth. Future trials should evaluate the effects of different types of infection screening programs.