Infección cervicovaginal como factor de riesgo para parto pretérmino / Cervicovaginal infection as a risk factor for premature labor

RESUMO

OBJECTIVE: To identify the possible association between cervicovaginal infections (CVI) and preterm delivery. DESIGN: Cohorts. REFERENCE FRAME Instituto Nacional de PerinatologÝa, Hospital Central Militar and Hospital General Regional No. 1, IMSS, Culiacßn, Sinaloa, MÚxico. PATIENTS Four hundred and sixty eight patients attending prenatal control and delivery care. INTERVENTIONS: Fresh smears, Gram stain, and cervicovaginal sample culture from samples obtained during the following gestational stages First sample at 16-24 weeks, second sample at 25-32 weeks, and third sample at 33-42 weeks. The following microorganisms were studied Candida albicans, Gardnerella vaginalis, Ureaplasma urealyticum, Streptococcus agalactiae, Mycoplasma hominis, Neisseria gonorrhoeae, Listeria monocytogenes, and Chlamydia trachomatis. In case of a positive culture, the specific treatment was indicated. MEASUREMENTS Positive or negative culture for each of the studied pathogens, and the presence or absence of a preterm delivery for each of the patients included in the study. RESULTS: Three hundred and ninety eight were still present at the end of the study, of which 156 had a CVI and 242 had no CVI. No differences between both groups were observed concerning preterm delivery. Significant relative risks were In the first stage, Ureaplasma urealyticum and Mycoplasma hominis with RR = 9.0 (6.81, 11.8); in the second stage, Ureaplasma urealyticum with RR = 6.2 (3.30, 11.7) and Escherichia coli with RR = 3.4 (1.33, 8.6); in the third stage, Ureaplasma urealyticum with RR = 9.19 (6.93, 12.1). The logistic regression analysis identified Ureaplasma urealyticum during the second stage with OR = 16.6 (2.9, 93.7), statistically significant with p = 0.001. The survival analysis showed differences between the two groups concerning pregnancy duration (p < 0.001). CONCLUSIONS: There is a difference in the duration in pregnancy in patients with CVI and without CVI. Ureaplasma urealyticum is consistently associated with preterm delivery.