Sexual intercourse association with asymptomatic bacterial vaginosis and Trichomonas vaginalis treatment in relationship to preterm birth

Vincenzo Berghella, Mark Klebanoff, Cora McPherson, J. Christopher Carey, John C. Hauth, J. M. Ernest, R. Phillip Heine, Ronald J. Wapner, Wayne Trout, Atef Moawad, Kenneth J. Leveno, Menachem Miodovnik, Baha M. Sibai, J. Peter Van Dorsten, Mitchell P. Dombrowski, Mary J. O'Sullivan, Michael Varner, Oded Langer

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

OBJECTIVE: The purpose of this study was to determine whether sexual intercourse was associated with the treatment efficacy or the incidence of preterm birth in two large randomized trials in which metronidazole treatment of bacterial vaginosis or Trichomonas vaginalis did not reduce preterm birth. STUDY DESIGN: Secondary analysis of two multicenter, double-blind, placebo-controlled trials in which women with asymptomatic bacterial vaginosis on Gram stain or asymptomatic T vaginalis on culture were randomized at 16 to 23 weeks of gestation to metronidazole or placebo. In both studies, women took 2 g of metronidazole or placebo in the presence of a nurse (first dose) and were given a second dose to take 48 hours later. This regimen was repeated (third and fourth doses) at 24 to 29 weeks. At the time of the third dose, bacterial vaginosis and T vaginalis specimens were collected again. Patients who were randomly selected to receive metronidazole were analyzed for bacterial vaginosis and T vaginalis at 24 to 29 weeks and for preterm birth of <37 weeks of gestation, according to intercourse between first and second doses and between the second and third doses. Continuous variables were compared with the use of the Wilcoxon ranksum test; categoric variables were compared with the use of the χ2 test, Fisher exact test, or the Mantel-Haenzel test of trend. RESULTS: Sexual intercourse between the first and second doses or between the second and third doses did not influence the incidence of bacterial vaginosis (18% vs 24%; relative risk, 0.7; 95% Cl, 0.5-1.1; and 23% vs 20%; relative risk, 1.2; 95% Cl, 0.9-1.6, respectively) or T vaginalis (4% vs 8%; relative risk, 0.5; 95% Cl, 0.1-3.6; and 5% vs 10%; relative risk, 0.5; 95% Cl, 0.2-1.1; respectively) at 24 to 29 weeks of gestation compared with no intercourse. In the T vaginalis trial, sexual intercourse between the first and second doses or between the second and third doses did not influence the incidence of preterm birth (13% vs 17%; relative risk, 0.8; 95% Cl, 0.3-2.1; and 16% vs 17%; relative risk, 1.0; 95% Cl, 0.6-1.6; respectively) compared with no intercourse. In the bacterial vaginosis trial, although sexual intercourse between the first and second doses did not influence the incidence of preterm birth (11% vs 12%; relative risk, 0.9; 95% Cl, 0.6-1.5), sexual intercourse between the second and third doses was associated with a reduction in the incidence of preterm birth (10% vs 16%; relative risk, 0.6; 95% Cl, 0.4-0.9) compared with no intercourse. CONCLUSION: Sexual intercourse was associated with neither the efficacy of metronidazole treatment of bacterial vaginosis or T vaginalis nor with the incidence of preterm birth. In the bacterial vaginosis study, intercourse between the second and third doses had a negative association with preterm birth.

Original languageEnglish (US)
Pages (from-to)1277-1282
Number of pages6
JournalAmerican Journal of Obstetrics and Gynecology
Volume187
Issue number5
DOIs
StatePublished - Nov 1 2002

Fingerprint

Bacterial Vaginosis
Trichomonas vaginalis
Coitus
Premature Birth
Metronidazole
Incidence
Placebos
Therapeutics
Pregnancy
Nurses

Keywords

  • Bacterial vaginosis
  • Preterm birth
  • Sex
  • Trichomonas vaginalis

ASJC Scopus subject areas

  • Medicine(all)
  • Obstetrics and Gynecology

Cite this

Sexual intercourse association with asymptomatic bacterial vaginosis and Trichomonas vaginalis treatment in relationship to preterm birth. / Berghella, Vincenzo; Klebanoff, Mark; McPherson, Cora; Carey, J. Christopher; Hauth, John C.; Ernest, J. M.; Heine, R. Phillip; Wapner, Ronald J.; Trout, Wayne; Moawad, Atef; Leveno, Kenneth J.; Miodovnik, Menachem; Sibai, Baha M.; Van Dorsten, J. Peter; Dombrowski, Mitchell P.; O'Sullivan, Mary J.; Varner, Michael; Langer, Oded.

In: American Journal of Obstetrics and Gynecology, Vol. 187, No. 5, 01.11.2002, p. 1277-1282.

Research output: Contribution to journalArticle

Berghella, V, Klebanoff, M, McPherson, C, Carey, JC, Hauth, JC, Ernest, JM, Heine, RP, Wapner, RJ, Trout, W, Moawad, A, Leveno, KJ, Miodovnik, M, Sibai, BM, Van Dorsten, JP, Dombrowski, MP, O'Sullivan, MJ, Varner, M & Langer, O 2002, 'Sexual intercourse association with asymptomatic bacterial vaginosis and Trichomonas vaginalis treatment in relationship to preterm birth', American Journal of Obstetrics and Gynecology, vol. 187, no. 5, pp. 1277-1282. https://doi.org/10.1067/mob.2002.127134
Berghella, Vincenzo ; Klebanoff, Mark ; McPherson, Cora ; Carey, J. Christopher ; Hauth, John C. ; Ernest, J. M. ; Heine, R. Phillip ; Wapner, Ronald J. ; Trout, Wayne ; Moawad, Atef ; Leveno, Kenneth J. ; Miodovnik, Menachem ; Sibai, Baha M. ; Van Dorsten, J. Peter ; Dombrowski, Mitchell P. ; O'Sullivan, Mary J. ; Varner, Michael ; Langer, Oded. / Sexual intercourse association with asymptomatic bacterial vaginosis and Trichomonas vaginalis treatment in relationship to preterm birth. In: American Journal of Obstetrics and Gynecology. 2002 ; Vol. 187, No. 5. pp. 1277-1282.
@article{1338d5bd470e4b1d913ae7763de1c34b,
title = "Sexual intercourse association with asymptomatic bacterial vaginosis and Trichomonas vaginalis treatment in relationship to preterm birth",
abstract = "OBJECTIVE: The purpose of this study was to determine whether sexual intercourse was associated with the treatment efficacy or the incidence of preterm birth in two large randomized trials in which metronidazole treatment of bacterial vaginosis or Trichomonas vaginalis did not reduce preterm birth. STUDY DESIGN: Secondary analysis of two multicenter, double-blind, placebo-controlled trials in which women with asymptomatic bacterial vaginosis on Gram stain or asymptomatic T vaginalis on culture were randomized at 16 to 23 weeks of gestation to metronidazole or placebo. In both studies, women took 2 g of metronidazole or placebo in the presence of a nurse (first dose) and were given a second dose to take 48 hours later. This regimen was repeated (third and fourth doses) at 24 to 29 weeks. At the time of the third dose, bacterial vaginosis and T vaginalis specimens were collected again. Patients who were randomly selected to receive metronidazole were analyzed for bacterial vaginosis and T vaginalis at 24 to 29 weeks and for preterm birth of <37 weeks of gestation, according to intercourse between first and second doses and between the second and third doses. Continuous variables were compared with the use of the Wilcoxon ranksum test; categoric variables were compared with the use of the χ2 test, Fisher exact test, or the Mantel-Haenzel test of trend. RESULTS: Sexual intercourse between the first and second doses or between the second and third doses did not influence the incidence of bacterial vaginosis (18{\%} vs 24{\%}; relative risk, 0.7; 95{\%} Cl, 0.5-1.1; and 23{\%} vs 20{\%}; relative risk, 1.2; 95{\%} Cl, 0.9-1.6, respectively) or T vaginalis (4{\%} vs 8{\%}; relative risk, 0.5; 95{\%} Cl, 0.1-3.6; and 5{\%} vs 10{\%}; relative risk, 0.5; 95{\%} Cl, 0.2-1.1; respectively) at 24 to 29 weeks of gestation compared with no intercourse. In the T vaginalis trial, sexual intercourse between the first and second doses or between the second and third doses did not influence the incidence of preterm birth (13{\%} vs 17{\%}; relative risk, 0.8; 95{\%} Cl, 0.3-2.1; and 16{\%} vs 17{\%}; relative risk, 1.0; 95{\%} Cl, 0.6-1.6; respectively) compared with no intercourse. In the bacterial vaginosis trial, although sexual intercourse between the first and second doses did not influence the incidence of preterm birth (11{\%} vs 12{\%}; relative risk, 0.9; 95{\%} Cl, 0.6-1.5), sexual intercourse between the second and third doses was associated with a reduction in the incidence of preterm birth (10{\%} vs 16{\%}; relative risk, 0.6; 95{\%} Cl, 0.4-0.9) compared with no intercourse. CONCLUSION: Sexual intercourse was associated with neither the efficacy of metronidazole treatment of bacterial vaginosis or T vaginalis nor with the incidence of preterm birth. In the bacterial vaginosis study, intercourse between the second and third doses had a negative association with preterm birth.",
keywords = "Bacterial vaginosis, Preterm birth, Sex, Trichomonas vaginalis",
author = "Vincenzo Berghella and Mark Klebanoff and Cora McPherson and Carey, {J. Christopher} and Hauth, {John C.} and Ernest, {J. M.} and Heine, {R. Phillip} and Wapner, {Ronald J.} and Wayne Trout and Atef Moawad and Leveno, {Kenneth J.} and Menachem Miodovnik and Sibai, {Baha M.} and {Van Dorsten}, {J. Peter} and Dombrowski, {Mitchell P.} and O'Sullivan, {Mary J.} and Michael Varner and Oded Langer",
year = "2002",
month = "11",
day = "1",
doi = "10.1067/mob.2002.127134",
language = "English (US)",
volume = "187",
pages = "1277--1282",
journal = "American Journal of Obstetrics and Gynecology",
issn = "0002-9378",
publisher = "Mosby Inc.",
number = "5",

}

TY - JOUR

T1 - Sexual intercourse association with asymptomatic bacterial vaginosis and Trichomonas vaginalis treatment in relationship to preterm birth

AU - Berghella, Vincenzo

AU - Klebanoff, Mark

AU - McPherson, Cora

AU - Carey, J. Christopher

AU - Hauth, John C.

AU - Ernest, J. M.

AU - Heine, R. Phillip

AU - Wapner, Ronald J.

AU - Trout, Wayne

AU - Moawad, Atef

AU - Leveno, Kenneth J.

AU - Miodovnik, Menachem

AU - Sibai, Baha M.

AU - Van Dorsten, J. Peter

AU - Dombrowski, Mitchell P.

AU - O'Sullivan, Mary J.

AU - Varner, Michael

AU - Langer, Oded

PY - 2002/11/1

Y1 - 2002/11/1

N2 - OBJECTIVE: The purpose of this study was to determine whether sexual intercourse was associated with the treatment efficacy or the incidence of preterm birth in two large randomized trials in which metronidazole treatment of bacterial vaginosis or Trichomonas vaginalis did not reduce preterm birth. STUDY DESIGN: Secondary analysis of two multicenter, double-blind, placebo-controlled trials in which women with asymptomatic bacterial vaginosis on Gram stain or asymptomatic T vaginalis on culture were randomized at 16 to 23 weeks of gestation to metronidazole or placebo. In both studies, women took 2 g of metronidazole or placebo in the presence of a nurse (first dose) and were given a second dose to take 48 hours later. This regimen was repeated (third and fourth doses) at 24 to 29 weeks. At the time of the third dose, bacterial vaginosis and T vaginalis specimens were collected again. Patients who were randomly selected to receive metronidazole were analyzed for bacterial vaginosis and T vaginalis at 24 to 29 weeks and for preterm birth of <37 weeks of gestation, according to intercourse between first and second doses and between the second and third doses. Continuous variables were compared with the use of the Wilcoxon ranksum test; categoric variables were compared with the use of the χ2 test, Fisher exact test, or the Mantel-Haenzel test of trend. RESULTS: Sexual intercourse between the first and second doses or between the second and third doses did not influence the incidence of bacterial vaginosis (18% vs 24%; relative risk, 0.7; 95% Cl, 0.5-1.1; and 23% vs 20%; relative risk, 1.2; 95% Cl, 0.9-1.6, respectively) or T vaginalis (4% vs 8%; relative risk, 0.5; 95% Cl, 0.1-3.6; and 5% vs 10%; relative risk, 0.5; 95% Cl, 0.2-1.1; respectively) at 24 to 29 weeks of gestation compared with no intercourse. In the T vaginalis trial, sexual intercourse between the first and second doses or between the second and third doses did not influence the incidence of preterm birth (13% vs 17%; relative risk, 0.8; 95% Cl, 0.3-2.1; and 16% vs 17%; relative risk, 1.0; 95% Cl, 0.6-1.6; respectively) compared with no intercourse. In the bacterial vaginosis trial, although sexual intercourse between the first and second doses did not influence the incidence of preterm birth (11% vs 12%; relative risk, 0.9; 95% Cl, 0.6-1.5), sexual intercourse between the second and third doses was associated with a reduction in the incidence of preterm birth (10% vs 16%; relative risk, 0.6; 95% Cl, 0.4-0.9) compared with no intercourse. CONCLUSION: Sexual intercourse was associated with neither the efficacy of metronidazole treatment of bacterial vaginosis or T vaginalis nor with the incidence of preterm birth. In the bacterial vaginosis study, intercourse between the second and third doses had a negative association with preterm birth.

AB - OBJECTIVE: The purpose of this study was to determine whether sexual intercourse was associated with the treatment efficacy or the incidence of preterm birth in two large randomized trials in which metronidazole treatment of bacterial vaginosis or Trichomonas vaginalis did not reduce preterm birth. STUDY DESIGN: Secondary analysis of two multicenter, double-blind, placebo-controlled trials in which women with asymptomatic bacterial vaginosis on Gram stain or asymptomatic T vaginalis on culture were randomized at 16 to 23 weeks of gestation to metronidazole or placebo. In both studies, women took 2 g of metronidazole or placebo in the presence of a nurse (first dose) and were given a second dose to take 48 hours later. This regimen was repeated (third and fourth doses) at 24 to 29 weeks. At the time of the third dose, bacterial vaginosis and T vaginalis specimens were collected again. Patients who were randomly selected to receive metronidazole were analyzed for bacterial vaginosis and T vaginalis at 24 to 29 weeks and for preterm birth of <37 weeks of gestation, according to intercourse between first and second doses and between the second and third doses. Continuous variables were compared with the use of the Wilcoxon ranksum test; categoric variables were compared with the use of the χ2 test, Fisher exact test, or the Mantel-Haenzel test of trend. RESULTS: Sexual intercourse between the first and second doses or between the second and third doses did not influence the incidence of bacterial vaginosis (18% vs 24%; relative risk, 0.7; 95% Cl, 0.5-1.1; and 23% vs 20%; relative risk, 1.2; 95% Cl, 0.9-1.6, respectively) or T vaginalis (4% vs 8%; relative risk, 0.5; 95% Cl, 0.1-3.6; and 5% vs 10%; relative risk, 0.5; 95% Cl, 0.2-1.1; respectively) at 24 to 29 weeks of gestation compared with no intercourse. In the T vaginalis trial, sexual intercourse between the first and second doses or between the second and third doses did not influence the incidence of preterm birth (13% vs 17%; relative risk, 0.8; 95% Cl, 0.3-2.1; and 16% vs 17%; relative risk, 1.0; 95% Cl, 0.6-1.6; respectively) compared with no intercourse. In the bacterial vaginosis trial, although sexual intercourse between the first and second doses did not influence the incidence of preterm birth (11% vs 12%; relative risk, 0.9; 95% Cl, 0.6-1.5), sexual intercourse between the second and third doses was associated with a reduction in the incidence of preterm birth (10% vs 16%; relative risk, 0.6; 95% Cl, 0.4-0.9) compared with no intercourse. CONCLUSION: Sexual intercourse was associated with neither the efficacy of metronidazole treatment of bacterial vaginosis or T vaginalis nor with the incidence of preterm birth. In the bacterial vaginosis study, intercourse between the second and third doses had a negative association with preterm birth.

KW - Bacterial vaginosis

KW - Preterm birth

KW - Sex

KW - Trichomonas vaginalis

UR - http://www.scopus.com/inward/record.url?scp=0036856112&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0036856112&partnerID=8YFLogxK

U2 - 10.1067/mob.2002.127134

DO - 10.1067/mob.2002.127134

M3 - Article

C2 - 12439520

AN - SCOPUS:0036856112

VL - 187

SP - 1277

EP - 1282

JO - American Journal of Obstetrics and Gynecology

JF - American Journal of Obstetrics and Gynecology

SN - 0002-9378

IS - 5

ER -