Abstract

A CASE CONTROL STUDY OF THE ASSOCIATION OF VAGINAL INFECTIONS WITH PRETERM LABOUR AND NEONATAL OUTCOME

Author(s): Tinu Philip, Neena Devassia

ACKGROUND Prematurity accounts for 85% of neonatal mortality. The neonatal morbidity associated with preterm labour is also very high. About 40% of unexplained preterm labour is due to vaginal infections. Screening for genital infections especially in high risk pregnancies will decrease the incidence of preterm labour and associated neonatal mortality and morbidity. MATERIALS AND METHODS The study was a case control study conducted in the department of Obstetrics and Gynaecology Labour Ward in a tertiary level hospital in the government sector in South India. One hundred cases of spontaneous preterm labour with no identifiable cause were included as the cases. Equal number of cases of uncomplicated term pregnancies delivering in the labour ward was included in the control arm. This study focuses on the incidence of vaginal infections in preterm labour compared to their incidence in term pregnancies. It also aims to identify the most common organism isolated in pregnant women with preterm labour and to study the neonatal morbidity and mortality of preterm births which are associated with vaginal infections. RESULTS The incidence of infections was 28% in the study group where as it was 10% in the control group. The organisms isolated were group B streptococcus, E. coli and Klebsiella. Group B streptococci were isolated in 38.29% cases of spontaneous preterm labour and bacterial vaginosis in 28.57% of preterm deliveries. There were 5 cases of neonatal sepsis in the culture positive group whereas there was no case of neonatal sepsis in the culture negative group. CONCLUSION This study emphasizes that vaginal infection is a significant risk factor for unexplained preterm labour. Identification of highrisk women for preterm labour, antenatal screening for vaginal infections and the use of the appropriate prophylactic antibiotics will help to decrease the neonatal morbidity and mortality associated with prematurity.