Signs of infection in Pap smears and risk of adverse pregnancy outcome.

Previous studies on whether signs of infection in Pap smears imply a risk factor for preterm delivery are conflicting. In a large population-based study, we combined information from the Swedish Medical Birth Register and the Swedish Pap Smear Screening Register to investigate whether signs of infection in Pap smears increase the risks of adverse pregnancy outcomes. Logistic regression analyses were used to estimate odds ratios (OR) for antepartum death, preterm or small-for-gestational-age delivery. The presence of Coccobacilli or Trichomonas vaginalis in Pap smears increased the risk of small-for-gestational-age delivery (OR 1.3 and 1.4, respectively). Signs of infection in Pap smears were generally not associated with an increased risk of antepartum death or preterm birth. However, the presence of Coccobacilli in Pap smears within 4 weeks before delivery was associated with a more than fourfold increase in risk of very preterm delivery (< or =31 weeks, OR 4.7). This indicates that if Coccobacilli are detected in Pap smears during the second trimester, antibacterial treatment may lower the risk of very preterm delivery.

[1]  J. Palmgren,et al.  Sinistrality—a side-effect of prenatal sonography: A comparative study of young men , 2001, Epidemiology.

[2]  J. Peipert,et al.  Screening for bacterial vaginosis in pregnancy. , 2001, American journal of preventive medicine.

[3]  G. Giacomini.  Permanent diagnosis of bacterial vaginosis: Gram stain or Papanicolaou stain? , 2000, Diagnostic cytopathology.

[4]  Neil Marlow,et al.  Neurologic and developmental disability after extremely preterm birth , 2000 .

[5]  J. Hauth,et al.  Intrauterine infection and preterm delivery. , 2000, The New England journal of medicine.

[6]  J. Brennan,et al.  Association between a shift in vaginal flora on papanicolaou smear and acute chorioamnionitis and preterm delivery , 1999, Diagnostic cytopathology.

[7]  M. Prey.  Routine pap smears for the diagnosis of bacterial vaginosis , 1999, Diagnostic cytopathology.

[8]  C. Michael.  The Papanicolaou Smear and the Obstetric Patient: A Simple Test with Great Benefits , 1999, Diagnostic cytopathology.

[9]  D. Rouse,et al.  Prevention of premature birth. , 1998, The New England journal of medicine.

[10]  M. Dombrowski,et al.  Is inflammation on Papanicolaou smear a risk factor for preterm delivery? , 1997, Fetal diagnosis and therapy.

[11]  A. Selbing,et al.  Intrauterine growth curves based on ultrasonically estimated foetal weights , 1996, Acta paediatrica.

[12]  Mary Frances Cotch,et al.  Association between Bacterial Vaginosis and Preterm Delivery of a Low-Birth-Weight Infant , 1995 .

[13]  J. Hauth,et al.  Preterm labor: emerging role of genital tract infections. , 1995, Infectious agents and disease.

[14]  E. Thom,et al.  The preterm prediction study: significance of vaginal infections. National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. , 1995, American journal of obstetrics and gynecology.

[15]  J. McFee,et al.  Prevention of premature birth by screening and treatment for common genital tract infections: results of a prospective controlled evaluation. , 1995, American journal of obstetrics and gynecology.

[16]  R. O. Davis,et al.  Risk Factors for Fetal Death in White, Black, and Hispanic Women , 1994, Obstetrics and gynecology.

[17]  Diane Solomon,et al.  The Bethesda System for reporting cervical/vaginal cytologic diagnoses: revised after the second National Cancer Institute Workshop, April 29-30, 1991. , 1993, Acta cytologica.

[18]  R. Blake,et al.  Does Evidence Of Inflammation On Papanicolaou Smears Of Pregnant Women Predict Preterm Labor And Delivery? , 1992, The Journal of the American Board of Family Medicine.

[19]  B. Källén,et al.  A Quality Study of a Medical Birth Registry , 1990, Scandinavian journal of social medicine.

[20]  K. Holmes,et al.  Diagnosis and clinical manifestations of bacterial vaginosis. , 1988, American journal of obstetrics and gynecology.