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Title: Association between increased antenatal vaginal pH and preterm birth rate : a systematic review
Authors : Weckend, Marina J.
Spineli, Loukia M.
Grylka, Susanne
Gross, Mechthild Maria
Published in : Journal of Perinatal Medicine
Publisher / Ed. Institution : De Gruyter
Issue Date: Jul-2018
License (according to publishing contract) : Licence according to publishing contract
Type of review: Peer review (Publication)
Language : English
Subjects : Abnormal flora; Infection; Pregnancy; Preterm birth; Systematic review; Vaginal pH
Subject (DDC) : 618: Gynecology, obstetrics and midwifery
Abstract: Background Worldwide, 14.9 million infants (11%) are born preterm each year. Up to 40% of preterm births (PTBs) are associated with genital tract infections. The vaginal pH can reflect changes in the vaginal milieu and, if elevated, indicates an abnormal flora or infection. Objective The aim of the study was to investigate whether an increased antenatal vaginal pH >4.5 in pre-labour pregnant women is associated with an increased PTB rate <37 completed weeks gestation. Search strategy Key databases included SCOPUS, EMBASE, MEDLINE, PsycInfo and the Cochrane Central Register of Controlled Trials, complemented by hand search, up to January 2017. Selection criteria Primary research reporting vaginal pH assessment in pre-labour pregnant women and PTB rate. Data collection and analysis Data extraction and appraisal were carried out in a pre-defined standardised manner, applying the Newcastle-Ottawa scale (NOS) and Cochrane risk of bias tool. Analysis included calculation of risk difference (RD) and narrative synthesis. It was decided to abstain from pooling of the studies due to missing information in important moderators. Main results Of 986 identified records, 30 were included in the systematic review. The risk of bias was considered mostly high (40%) or moderate (37%). Fifteen studies permitted a calculation of RD. Of these, 14 (93%) indicated a positive association between increased antenatal vaginal pH and PTB (RD range: 0.02-0.75). Conclusions An increased antenatal vaginal pH >4.5 may be associated with a higher risk for PTB. It is recommended to conduct a randomised controlled trial (RCT) to investigate the effectiveness of antenatal pH screening to prevent PTB. Tweetable abstract Pregnant women with an increased vaginal pH >4.5 may be at higher risk to experience preterm birth.
Further description : Erworben im Rahmen der Schweizer Nationallizenzen (
Departement: Gesundheit
Organisational Unit: Institute of Midwifery (IHB)
Publication type: Article in scientific Journal
DOI : 10.1515/jpm-2018-0097
ISSN: 1619-3997
Restricted until : 2019-11-07
Appears in Collections:Publikationen Gesundheit

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