Readily treatable reproductive tract infections and preterm birth among black women

Objective: This study sought to quantify the risks of preterm birth that are ascribable to potentially treatable reproductive tract infections among black women in Denver, Colorado. Study design: A secondary analysis was conducted of 4 prospective studies in Denver, Colorado, that included 1038 women who were enrolled at < 29 weeks of gestation and whose cases were followed through delivery. Rates of preterm birth, preterm labor, and preterm premature rupture of membranes were the primary outcomes that were examined. Results: Bacterial vaginosis, infection with Chlamydia trachomatis, Trichonzonas vaginalis, Mycoplasma hominis, Neisseria gonorrhoeae, and group B streptococcal colonization were more common among black women (P < 0.1) than among comparators. Preterm birth occurred more often among black women with infections that were being studied (20.4%), compared with uninfected black women (9.5%; relative risk, 2.2; 95% CI, 1.1-4.1). Up to 42% of preterm births among black women were attributable to the presence of bacterial vaginosis, T vaginalis, or C trachomatis alone or in combinations. The risk for preterm birth among infected black women who received Centers for Disease Control and Prevention recommended treatment was reduced significantly (relative risk, 0.16; 95% CI, 0.04-0.66). Conclusion: Black women have increased risks of prematurity that are associated with prevalent reproductive tract infections during pregnancy. Preterm birth among similar urban black women could be reduced by > 40% by the screening and treatment of common genitourinary tract infections in pregnancy. (c) 2006 Mosby, Inc. All rights reserved.