Late miscarriage and preterm birth after treatment with clindamycin: A randomised consent design study according to Zelen

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Fältnamn	Indikatorer	Metadata
000		03642naa a2200325 4500
001		oai:DiVA.org:liu-35129
003		SwePub
008		091010s2006 \| \|\|\|\|\|\|\|\|\|\|\|000 \|\|eng\|
024	7	a https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-351292 URI
024	7	a https://doi.org/10.1111/j.1471-0528.2006.00946.x2 DOI
040		a (SwePub)liu
041		a engb eng
042		9 SwePub
072	7	a ref2 swepub-contenttype
072	7	a art2 swepub-publicationtype
100	1	a Larsson, Per-Göran,d 1953-u Linköpings universitet,Hälsouniversitetet,Genus och medicin4 aut0 (Swepub:liu)perla12
245	1 0	a Late miscarriage and preterm birth after treatment with clindamycin :b A randomised consent design study according to Zelen
264	1	b Wiley,c 2006
338		a print2 rdacarrier
520		a Objective: To screen for bacterial vaginosis (BV) and to investigate the effect of treatment with vaginal clindamycin in order to observe the effect on late miscarriage and delivery prior to 37 completed weeks (primary outcome). Design: Randomised consent design for clinical trials according to Zelen. Setting: Southeast region of Sweden. Population: A total of 9025 women were screened in early pregnancy. Methods: A total of 819 women with a Nugent score of 6 and above were considered to have BV and treated according to Zelen allocation. The incidence of late miscarriage and spontaneous (noniatrogenic) preterm birth was assessed. Main outcome measures: Late miscarriage and spontaneous preterm delivery before 37 weeks. Results: Therapy with vaginal clindamycin had no significant impact on the incidence of spontaneous preterm delivery prior to 37 completed weeks, OR 0.90, 95% CI 0.40-2.02 (primary outcome variable). However, only 1 of 11 women in the treatment group versus 5 of 12 in the control group delivered prior to 33 completed weeks, OR 0.14, 95% CI 0.02-0.95. Treatment was associated with 32 days longer gestation for the 23 participants who had late miscarriage or spontaneous preterm birth (P= 0.024, Mann-Whitney U test) and significantly fewer infants had a birthweight below 2500 g (secondary outcome). A follow up of infants born preterm 4 years postnatally indicated that extending gestational age did not increase the number of sequelae. Conclusions: Clindamycin vaginal cream therapy was associated with significantly prolonged gestation and reduced cost of neonatal care in women with BV. Early screening for BV and treatment with clindamycin saved approximately €27 per woman. © RCOG 2006 BJOG An International Journal of Obstetrics and Gynaecology.
653		a MEDICINE
653		a MEDICIN
700	1	a Fåhraeus, Lars,d 1939-u Östergötlands Läns Landsting,Linköpings universitet,Hälsouniversitetet,Obstetrik och gynekologi,Kvinnokliniken i Linköping4 aut0 (Swepub:liu)larfa31
700	1	a Carlsson, Bodil,d 1949-u Östergötlands Läns Landsting,Linköpings universitet,Hälsouniversitetet,Klinisk mikrobiologi4 aut0 (Swepub:liu)bodca74
700	1	a Jakobsson, Tell,d 1951-u Östergötlands Läns Landsting,Linköpings universitet,Hälsouniversitetet,Klinisk mikrobiologi4 aut0 (Swepub:liu)telja07
700	1	a Forsum, Urban,d 1946-u Östergötlands Läns Landsting,Linköpings universitet,Hälsouniversitetet,Klinisk mikrobiologi4 aut0 (Swepub:liu)urbfo84
710	2	a Linköpings universitetb Hälsouniversitetet4 org
773	0	t British Journal of Obstetrics and Gynecologyd : Wileyg 113:6, s. 629-637q 113:6<629-637x 1470-0328x 1471-0528
856	4 8	u https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-35129
856	4 8	u https://doi.org/10.1111/j.1471-0528.2006.00946.x

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