Effect of antibiotic exposure on nugent score among pregnant women with and without bacterial vaginosis

Brenna Anderson, Yuan Zhao, William W. Andrews, Donald J. Dudley, Baha Sibai, Jay D. Iams, Ronald J. Wapner, Michael W. Varner, Steve N. Caritis, Mary Jo O'Sullivan

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Objective: To evaluate whether vaginal flora is altered by antibiotic exposure and associated with a risk of preterm birth, particularly among women with initially normal vaginal flora. Methods: This was a secondary analysis of a randomized trial of metronidazole and erythromycin for the prevention of preterm birth among women with a positive fetal fibronectin test. Vaginal swabs for Nugent Gram stain score were collected for classification of bacterial vaginosis before and after antibiotic exposure and read at a central laboratory. Change in Nugent score was assessed for women with (score 7 or higher) or without (score lower than 7) bacterial vaginosis. Linear regression analysis evaluated whether change in Nugent score was associated with preterm birth. Results: Two hundred women without and 69 women with bacterial vaginosis had Gram stain performed before and after antibiotic therapy. Median Nugent score for all women declined from 4.0 to 2.0 after antibiotic therapy (P<.001). Nugent score declined both for those without (from 2.0 to 1.5, P=.11) and, more dramatically, those with bacterial vaginosis (from 8.0 to 3.0, P<.01). The components of the Nugent score that were affected by antibiotic exposure were similar among women with and without bacterial vaginosis. Antibiotic exposure and the change in Nugent score were unrelated to preterm birth among bacterial vaginosis-negative women. Conclusion: Antibiotic exposure is not associated with preterm birth and does not worsen Nugent score among women with normal vaginal flora and positive fetal fibronectin.

Original languageEnglish
Pages (from-to)844-849
Number of pages6
JournalObstetrics and Gynecology
Volume117
Issue number4
DOIs
StatePublished - Apr 1 2011
Externally publishedYes

Fingerprint

Bacterial Vaginosis
Pregnant Women
Anti-Bacterial Agents
Premature Birth
Fibronectins
Metronidazole
Erythromycin
Linear Models
Regression Analysis

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Anderson, B., Zhao, Y., Andrews, W. W., Dudley, D. J., Sibai, B., Iams, J. D., ... O'Sullivan, M. J. (2011). Effect of antibiotic exposure on nugent score among pregnant women with and without bacterial vaginosis. Obstetrics and Gynecology, 117(4), 844-849. https://doi.org/10.1097/AOG.0b013e318209dd57

Effect of antibiotic exposure on nugent score among pregnant women with and without bacterial vaginosis. / Anderson, Brenna; Zhao, Yuan; Andrews, William W.; Dudley, Donald J.; Sibai, Baha; Iams, Jay D.; Wapner, Ronald J.; Varner, Michael W.; Caritis, Steve N.; O'Sullivan, Mary Jo.

In: Obstetrics and Gynecology, Vol. 117, No. 4, 01.04.2011, p. 844-849.

Research output: Contribution to journalArticle

Anderson, B, Zhao, Y, Andrews, WW, Dudley, DJ, Sibai, B, Iams, JD, Wapner, RJ, Varner, MW, Caritis, SN & O'Sullivan, MJ 2011, 'Effect of antibiotic exposure on nugent score among pregnant women with and without bacterial vaginosis', Obstetrics and Gynecology, vol. 117, no. 4, pp. 844-849. https://doi.org/10.1097/AOG.0b013e318209dd57
Anderson, Brenna ; Zhao, Yuan ; Andrews, William W. ; Dudley, Donald J. ; Sibai, Baha ; Iams, Jay D. ; Wapner, Ronald J. ; Varner, Michael W. ; Caritis, Steve N. ; O'Sullivan, Mary Jo. / Effect of antibiotic exposure on nugent score among pregnant women with and without bacterial vaginosis. In: Obstetrics and Gynecology. 2011 ; Vol. 117, No. 4. pp. 844-849.
@article{c1b7e42662b7463ab02752e9e1c1651a,
title = "Effect of antibiotic exposure on nugent score among pregnant women with and without bacterial vaginosis",
abstract = "Objective: To evaluate whether vaginal flora is altered by antibiotic exposure and associated with a risk of preterm birth, particularly among women with initially normal vaginal flora. Methods: This was a secondary analysis of a randomized trial of metronidazole and erythromycin for the prevention of preterm birth among women with a positive fetal fibronectin test. Vaginal swabs for Nugent Gram stain score were collected for classification of bacterial vaginosis before and after antibiotic exposure and read at a central laboratory. Change in Nugent score was assessed for women with (score 7 or higher) or without (score lower than 7) bacterial vaginosis. Linear regression analysis evaluated whether change in Nugent score was associated with preterm birth. Results: Two hundred women without and 69 women with bacterial vaginosis had Gram stain performed before and after antibiotic therapy. Median Nugent score for all women declined from 4.0 to 2.0 after antibiotic therapy (P<.001). Nugent score declined both for those without (from 2.0 to 1.5, P=.11) and, more dramatically, those with bacterial vaginosis (from 8.0 to 3.0, P<.01). The components of the Nugent score that were affected by antibiotic exposure were similar among women with and without bacterial vaginosis. Antibiotic exposure and the change in Nugent score were unrelated to preterm birth among bacterial vaginosis-negative women. Conclusion: Antibiotic exposure is not associated with preterm birth and does not worsen Nugent score among women with normal vaginal flora and positive fetal fibronectin.",
author = "Brenna Anderson and Yuan Zhao and Andrews, {William W.} and Dudley, {Donald J.} and Baha Sibai and Iams, {Jay D.} and Wapner, {Ronald J.} and Varner, {Michael W.} and Caritis, {Steve N.} and O'Sullivan, {Mary Jo}",
year = "2011",
month = "4",
day = "1",
doi = "10.1097/AOG.0b013e318209dd57",
language = "English",
volume = "117",
pages = "844--849",
journal = "Obstetrics and Gynecology",
issn = "0029-7844",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

TY - JOUR

T1 - Effect of antibiotic exposure on nugent score among pregnant women with and without bacterial vaginosis

AU - Anderson, Brenna

AU - Zhao, Yuan

AU - Andrews, William W.

AU - Dudley, Donald J.

AU - Sibai, Baha

AU - Iams, Jay D.

AU - Wapner, Ronald J.

AU - Varner, Michael W.

AU - Caritis, Steve N.

AU - O'Sullivan, Mary Jo

PY - 2011/4/1

Y1 - 2011/4/1

N2 - Objective: To evaluate whether vaginal flora is altered by antibiotic exposure and associated with a risk of preterm birth, particularly among women with initially normal vaginal flora. Methods: This was a secondary analysis of a randomized trial of metronidazole and erythromycin for the prevention of preterm birth among women with a positive fetal fibronectin test. Vaginal swabs for Nugent Gram stain score were collected for classification of bacterial vaginosis before and after antibiotic exposure and read at a central laboratory. Change in Nugent score was assessed for women with (score 7 or higher) or without (score lower than 7) bacterial vaginosis. Linear regression analysis evaluated whether change in Nugent score was associated with preterm birth. Results: Two hundred women without and 69 women with bacterial vaginosis had Gram stain performed before and after antibiotic therapy. Median Nugent score for all women declined from 4.0 to 2.0 after antibiotic therapy (P<.001). Nugent score declined both for those without (from 2.0 to 1.5, P=.11) and, more dramatically, those with bacterial vaginosis (from 8.0 to 3.0, P<.01). The components of the Nugent score that were affected by antibiotic exposure were similar among women with and without bacterial vaginosis. Antibiotic exposure and the change in Nugent score were unrelated to preterm birth among bacterial vaginosis-negative women. Conclusion: Antibiotic exposure is not associated with preterm birth and does not worsen Nugent score among women with normal vaginal flora and positive fetal fibronectin.

AB - Objective: To evaluate whether vaginal flora is altered by antibiotic exposure and associated with a risk of preterm birth, particularly among women with initially normal vaginal flora. Methods: This was a secondary analysis of a randomized trial of metronidazole and erythromycin for the prevention of preterm birth among women with a positive fetal fibronectin test. Vaginal swabs for Nugent Gram stain score were collected for classification of bacterial vaginosis before and after antibiotic exposure and read at a central laboratory. Change in Nugent score was assessed for women with (score 7 or higher) or without (score lower than 7) bacterial vaginosis. Linear regression analysis evaluated whether change in Nugent score was associated with preterm birth. Results: Two hundred women without and 69 women with bacterial vaginosis had Gram stain performed before and after antibiotic therapy. Median Nugent score for all women declined from 4.0 to 2.0 after antibiotic therapy (P<.001). Nugent score declined both for those without (from 2.0 to 1.5, P=.11) and, more dramatically, those with bacterial vaginosis (from 8.0 to 3.0, P<.01). The components of the Nugent score that were affected by antibiotic exposure were similar among women with and without bacterial vaginosis. Antibiotic exposure and the change in Nugent score were unrelated to preterm birth among bacterial vaginosis-negative women. Conclusion: Antibiotic exposure is not associated with preterm birth and does not worsen Nugent score among women with normal vaginal flora and positive fetal fibronectin.

UR - http://www.scopus.com/inward/record.url?scp=79953216739&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79953216739&partnerID=8YFLogxK

U2 - 10.1097/AOG.0b013e318209dd57

DO - 10.1097/AOG.0b013e318209dd57

M3 - Article

C2 - 21422854

AN - SCOPUS:79953216739

VL - 117

SP - 844

EP - 849

JO - Obstetrics and Gynecology

JF - Obstetrics and Gynecology

SN - 0029-7844

IS - 4

ER -