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A study is conducted on 658 women with asymptomatic bacterial vaginosis to determine the time course of the regression of asymptomatic bacterial vaginosis in pregnancy with and without treatment and the probability of spontaneous resolution with placebo. Women undergoing placebo treatment had a significant remission of bacterial vaginosis over ten weeks and the remission is more common when the initial vaginal microbiologic disturbance is less.

Having sexual intercourse during pregnancy does not appear to affect the treatment of bacterial vaginosis or the risk of premature birth, according to two large studies of bacterial vaginosis. Bacterial vaginosis is a bacterial infection of the vagina. Some studies suggest that intercourse during pregnancy increases the risk of premature birth but other studies have not confirmed the association.

Background: Several studies have suggested that pregnant women infected with Trichomonas vaginalis may be at increased risk of an adverse outcome. Goal: To evaluate prospectively the association between T. vaginalis and risk of adverse pregnancy outcome in a large cohort of ethnically diverse women. Study Design: At University-affiliated hospitals and antepartum clinics in five United States cities, 13,816 women (5,241 black, 4,226 Hispanic, and 4,349 white women) were enrolled at mid-gestation, tested for T vaginalis by culture, and followed up until delivery. Results: The prevalence of T vaginalis infection at enrollment was 12.6%. Race-specific prevalence rates were 22.8% for black, 6.6% for Hispanic, and 6.1% for white women. After multivariate analysis, vaginal infection with T vaginalis at mid-gestation was significantly associated with low birth weight (odds ratio 1.3; 95% confidence interval 1.1 to 1.5), preterm delivery (odds ratio 1.3; 95% confidence interval 1.1 to 1.4), and preterm delivery of a low birth weight infant (odds ratio 1.4; 95% confidence interval 1.1 to 1.6). The at tributable risk of T vaginalis infection associated with low birth weight in blacks was 11% compared with 1.6% in Hispanics and 1.5% in whites. Conclusions: After considering other recognized risk factors including co-infections, pregnant women infected with T. vaginalis at mid-gestation were statistically significantly more likely to have a low birth weight infant, to deliver preterm, and to have a preterm low birth weight infant. Compared with whites and Hispanics, T vaginalis infection accounts for a disproportionately larger share of the low birth weight rate in blacks., Pregnant women infected with Trichomonas vaginalis appear to be at increased risk for delivery complications. T. vaginalis infection and delivery complication rates were determined among 13,816 pregnant women. Overall, 12.6% of the women were infected with T. vaginalis mid-way through pregnancy. Infected women were 1.3 times more likely to deliver prematurely or to have a low birth weight infant. They were 1.4 times more likely to deliver a low-birth-weight infant prematurely. The highest infection rates were seen among black women who also had a higher risk of low-birth-weight infants than other ethnic groups.

Cocaine and marijuana use may not be associated with low birth weight or preterm birth. However, one-third of pregnant women smoked and cigarette smoking is associated with low birth weight. The effect of cocaine, marijuana, and cigarette smoking was evaluated among 7470 women attending seven geographically diverse clinics. Drug exposure was determined through an interview that took place at 23 to 26 weeks gestation and through periodic assay of blood serum. Overall, 2.3% of women used cocaine and 11% used marijuana. Marijuana had no adverse effects on birth outcomes. Cocaine use increased the odds of premature separation of the placenta from the uterine wall by 4.2 times. Cigarette smokers had 1.5 times the odds of having a low birth weight baby. Fifteen percent of all cases of low birth weight could have been prevented if none of the women in this population had smoked cigarettes. Smoking cessation programs would have more effect on outcomes than drug detection programs among the general population.

Genital infections during pregnancy have been associated with prematurity and low birth weight. However, the association between infections with organisms such as Ureaplasma urealyticum and poor pregnancy outcome has not been consistent. In some studies, antibiotic treatment of women infected with U. urealyticum or other bacteria resulted in fewer premature infants, while other studies suggested that prematurity and U. urealyticum infection are not associated. As part of a large study, the effects of the antibiotic erythromycin or placebo on the pregnancy outcomes of 1,181 women were evaluated. This study differed from others in that women with infections in addition to U. urealyticum were excluded. The subjects received treatment beginning between 26 and 30 weeks gestation to term, three times daily. Erythromycin treatment did not eliminate the organism from subjects' lower genital tracts, and no effect on pregnancy outcome was found. (Consumer Summary produced by Reliance Medical Information, Inc.)

The effects of physical activity during pregnancy on premature birth and birth weight has been a subject of considerable investigation; however, results have been conflicting. To learn more about this issue, 7,101 women who were part of a multicenter study were interviewed concerning their physical activity during a typical day in the first five months of pregnancy. The interviews took place between 23 and 26 weeks' gestation, and results were analyzed after pregnancy ended. Demographic differences were found for different activity levels; thus, prolonged heavy work and standing were more common among Hispanic women and women interviewed at the San Antonio center. Women with more education were less likely to participate in such work. These differences are discussed in detail. Women who spent more time standing had a slightly increased risk of premature birth; with eight or more hours per day spent standing, the risk of delivery before 37 weeks' gestation was 28 percent higher than with no standing. Premature delivery was more common among women who were black, smokers, or lived in Texas. Heavy work, though, was not associated with preterm birth. Women who performed light work or exercise were less likely than those who did not work to deliver preterm. No trend was seen that related birth weight to activity level. The dilemma faced by employed women who may be required to work to retain their salaries and medical benefits, when the work itself may threaten the pregnancy, is noted. (Consumer Summary produced by Reliance Medical Information, Inc.)