Objective: To determine the prevalence of Lactobacillus spp. in vaginal flora during pregnancy and to assess the protective effects of lactobacilli against preterm labour.
Design: Cross-sectional analysis of Lactobacillus spp. in the vaginal flora of the pregnant coloured population of the Western Cape.
Participants: A total of 480 consecutive pregnant women, aged 13-48 years, seen at their first visit to the Tygerberg Hospital antenatal clinic.
Main Outcome Measures: Preterm labour, i.e. before 34 and 37 weeks' gestation, premature rupture of membranes, intra-uterine growth retardation and perinatal deaths.
Results: A total of 163 patients had negative cultures and 317 positive cultures for lactobacilli, aerobes or both. Delivery before 37 weeks occurred in 18% and 20% of the two groups, respectively. Lactobacillus only was cultured from 116 patients and Lactobacillus and/or other aerobes from 201 patients. Preterm labour occurred in 20% of the first group and in 19% of the second group. The perinatal outcome in patients from whom lactobacilli only were cultivated did not differ from patients from whom other aerobes and lactobacilli or other aerobes only were cultured.
Conclusion: In patients at high risk for preterm labour, the presence of lactobacilli in the vagina does not seem to play a protective role.
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BMJ Open
January 2025
Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK.
Objectives: How are socioeconomic inequalities modified by, or how do they interact with, preterm birth?
Design: Narrative systematic review of quantitative observational studies of an interaction, or effect modification, between preterm birth and socioeconomic status.
Data Sources: Five databases were searched for studies published between January 2000 and June 2020. Title and abstract were reviewed to identify articles for dual screening.
Br J Hosp Med (Lond)
January 2025
Department of Obstetrics and Gynecology, The First Clinical Medical College of Three Gorges University, Yichang Central People's Hospital, Yichang, Hubei, China.
Gestational diabetes mellitus (GDM) is a common complication during pregnancy. This retrospective study investigates the correlation between umbilical blood flow index and maternal-fetal outcomes in pregnant women with GDM, aiming to contribute to evidence-based risk assessment and management strategy in this high-risk obstetric population. This retrospective study recruited 119 pregnant women with GDM who were admitted to the Yichang Central People's Hospital, between January 2022 and January 2024.
View Article and Find Full Text PDFBMC Public Health
January 2025
Department of Emergency, Hainan Clinical Research Center for Acute and Critical Diseases, The Second Affiliated Hospital of Hainan Medical University, Haikou, Hainan, 570100, China.
Background: Due to climate change, the frequency and intensity of heat waves and other extreme weather events are rapidly increasing. Compared to the general population, pregnant women and fetuses are increasingly vulnerable to the effects of extreme temperatures and are associated with the occurrence of adverse birth outcomes, including preterm birth (PTB). However, its risk of preterm birth is currently uncertain.
View Article and Find Full Text PDFLancet Child Adolesc Health
February 2025
The Royal Women's Hospital, Melbourne, VIC, Australia; Department of Obstetrics, Gynaecology and Newborn Health, The University of Melbourne, Melbourne, VIC, Australia; Murdoch Children's Research Institute, Melbourne, VIC, Australia.
In this Viewpoint, we discuss the challenges facing perinatal clinical researchers, many of which are unique to this field, and how traditional two-arm randomised trials using frequentist analysis might no longer be fit for purpose for perinatology. We propose a solution: the adoption of adaptive platform trials (APTs) with Bayesian methodology to address perinatal research questions to improve outcomes of preterm birth. APTs use a master protocol as a foundation to efficiently assess multiple interventions simultaneously for a particular disease.
View Article and Find Full Text PDFJ Int Med Res
January 2025
Department of Clinical Medical Sciences, College of Medicine, University of Sulaimani, Sulaimaniyah, Iraq.
Objective: To evaluate the value of the urocortin (UCN) level to predict preterm delivery in women with threatened preterm labour.
Methods: This prospective cohort study included 96 women with a singleton pregnancy between 28 and 34 weeks of gestation who were admitted with threatened preterm labour. The participants were monitored until delivery.
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