A Cochrane review [Abstract] 1 included 1 study. 4155 women were randomly assigned either to an intervention group where infections (bacterial vaginosis [BV], trichomonas vaginalis and candidiasis) were screened and treated or to a control group where the results of the screening program were not reported. Preterm birth before 37 weeks was significantly lower in the intervention group compared to the control group (3% vs 5%; RR 0.55, 95% CI 0.41 to 0.75). The incidence of preterm birth for low birthweight preterm infants (equal to or below 2500 g) and very low birthweight infants (equal to or below 1500 g) were significantly lower in the intervention group than in the control group (RR 0.48, 95% CI 0.34 to 0.66 and RR 0.34; 95% CI 0.15 to 0.75, respectively). However, reduced rate of preterm birth was observed especially in mothers with candidiasis (7/258 in the intervention group and 20/238 in the control group) or with normal vaginal flora and less in women with BV (preterm birth 5/144 in the intervention group and 8/135 in the control group).
Comment: The quality of evidence is downgraded by study quality (no blinding of the treatment, no intention-to-treat analysis) and by inconsistency (heterogeneity in results in different subgroups).
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