Quantitative microbiologic models for preterm delivery - PubMed (original) (raw)

Quantitative microbiologic models for preterm delivery

Andrew B Onderdonk et al. J Clin Microbiol. 2003 Mar.

Abstract

Preterm delivery (PTD) is the leading cause of infant morbidity and mortality in the United States. An epidemiological association between PTD and various bacteria that are part of the vaginal microflora has been reported. No single bacterial species has been identified as being causally associated with PTD, suggesting a multifactorial etiology. Quantitative microbiologic cultures have been used previously to define normal vaginal microflora in a predictive model. These techniques have been applied to vaginal swab cultures from pregnant women in an effort to develop predictive microbiologic models for PTD. Logistic regression analysis with microbiologic information was performed for various risk groups, and the probability of a PTD was calculated for each subject. Four predictive models were generated by using the quantitative microbiologic data. The area under the curve (AUC) for the receiver operating curves ranged from 0.74 to 0.94, with confidence intervals (CI) ranging from 0.62 to 1. The model for the previous PTD risk group with the highest percentage of PTDs had an AUC of 0.91 (CI, 0.79 to 1). It may be possible to predict PTD by using microbiologic risk factors measured once the gestation period has reached the 20-week time point.

PubMed Disclaimer

Figures

FIG. 1.

FIG. 1.

Correlation matrix for all subjects. ∗, significance at P value of <0.05. Abbreviations: gestborn, gestational age at birth; ph, pH; totalan, all anaerobes; totalae, all aerobes; maxlacto, maximum count of Lactobacillus spp.; maxh2o2, maximum count of H2O2-producing Lactobacillus spp.; maxprevo, maximum count of Prevotella spp.; ecoli, Escherichia coli count; maxpepto, maximum count of Peptostreptococcus spp.; maxstrep, maximum count of Strepotococcus spp.; maxstaph, maximum count of Staphylococcus spp.; maxcoryn, maximum count of Corynebacterium spp.; gardner, Gardnerella sp. count; avgtot, average total number of bacteria.

Similar articles

Cited by

References

    1. Abele-Horn, M., J. Peters, O. Genzel-Boroviczeny, C. Wolff, A. Zimmermann, and W. Gottschling. 1997. Vaginal Ureaplasma urealyticum colonization: influence on pregnancy outcome and neonatal morbidity. Infection 25:286-291. - PubMed
    1. Amsel, R., P. A. Totten, C. A. Spiegel, K. C. Chen, D. Eschenbach, and K. K. Holmes. 1983. Nonspecific vaginitis. Diagnostic criteria and microbial and epidemiologic associations. Am. J. Med. 74:14-22. - PubMed
    1. Antonio, M. A., S. E. Hawes, and S. L. Hillier. 1999. The identification of vaginal Lactobacillus species and the demographic and microbiologic characteristics of women colonized by these species. J. Infect. Dis. 180:1950-1956. - PubMed
    1. Antsaklis, A., G. Daskalakis, S. Michalas, and D. Aravantinos. 1997. Erythromycin treatment for subclinical Ureaplasma urealyticum infection in preterm labor. Fetal Diagn. Ther. 12:89-92. - PubMed
    1. Barefoot, S. F., and T. R. Klaenhammer. 1983. Detection and activity of lactacin B, a bacteriocin produced by Lactobacillus acidophilus. Appl. Environ. Microbiol. 45:1808-1815. - PMC - PubMed

Publication types

MeSH terms

LinkOut - more resources