Infection & Inflammation

Quicklinks

Infection and Inflammation and its impact on Pregnancy:

Genitourinary tract infections are well-established causes for a large proportion of potentially preventable preterm births and other complications in pregnancy. Adverse outcomes related to infection include:

The rationale for improving pregnancy outcomes by screening and treating infection during pregnancy is supported by the literature and guidelines from both the American College of Obstetrics and Gynecology and the Centers for Disease Control and Prevention. Results from research trials suggest that one preterm birth can be prevented for every:

• 21 women who receive treatment for asymptomatic bacteriuria² 
• 10 women who receive treatment for Chlamydia¹
• 10 women treated for bacterial vaginosis³

References
1. Martin DH, Eschenbach DA, Cotch MF, et al. "Double-blind, placebo-controlled treatment trial of Chlamydia trachomatis Endocervical infections in pregnant women." Inf Dis Obstet Gyncol 1997;5: 10-7.
2. Smaill F. "Antibiotics for asymptomatic bacteriuria in pregnancy." Cochrane Database of Systematic Reviews. 2001.
3. Ugwumadu, A, Manyonda I, Reid F, Hay P. "Effect of early oral clindamycin on late miscarriage and preterm delivery in asymptomatic women with abnormal vaginal flora and bacterial vaginosis: a randomized controlled trial." Lancet 2003; 361: 983-86.

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• CDC Fact Sheet and Guidelines: the Centers for Disease Control and Prevention has a fact sheet that provides an overview of the adverse effects that Sexually Transmitted Infections have on Pregnancy and what women can do to treat and prevent them.
• CDC Treatment Guidelines 2010
• CDC Group B Strep Disease
• LA Best Babies Network's Brief "Bacterial Vaginosis"
• LA Best Babies Network Toolkit: Managing Infections in Pregnancy
  
• California STD/HIV Prevention Training Center

Forms

• CPSP Forms

The Care Model for Prenatal Care: this is a model created by Dr. Wagner at the Institute for Healthcare Innovation originally developed for chronic disease but adapted for perinatal care.  The model promotes a comprehensive look at systems that impact health. 

• Sample Infection PDSA
• Bacterial Vaginosis (BV) Patient Information Fact Sheets: English or Spanish

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• Medline Plus - Infections & Pregnancy: updated articles and resources from the National Library of Medicine and other government agencies and health-related organizations

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• "Association Between Bacterial Vaginosis or Chlamydial Infection and Miscarriage Before 16 Weeks Gestation: Prospective Community Based Cohort Study." Brit Med J 2002; 325: 1334-6.
• "Association of Bacterial Vaginosis with a History of Second Trimester Miscarriage." H Repro 1996; 11: 1575-8
• "Effect of Early Oral Clindamycin on Late Miscarriage and Preterm Delivery in Asymptomatic Women with Abnormal Vaginal Flora and Vacterial Vaginosis: A Randomised Controlled Trial." Lancet 2003; 361:983-88
• "Influence of Bacterial Vaginosis on Conception and Miscarriage in the First Trimester: Cohort Study." Brit Med J 1999; 319:220-3
• "Intravaginal Clindamycin to Reduce Preterm Birth in Women With Abnormal Genital Tract Flora." Obstet Gynecol 2003; 101:516-22

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