Genitourinary Infection and Their Association With Preterm Labour: A Case Control Study

Background and Objectives: Preterm birth is a major determinant of neonatal morbidity and mortality and has long term adverse consequences on health. Worldwide incident of preterm birth ranges between 6-11%.Whereas it is around 25% in developing countries.This study aims to study relation of genitourinary infection and preterm labour and to select an appropriate antibiotic therapy. A case control study Materials and Methods: was conducted from one year at the department of OBG, VIMS, Ballari. All pregnant women meeting the inclusion criteria and those who gave valid consent are recruited in the study.The women reporting to labour room in preterm labour pain were taken as study group (GROUP A).A detailed pelvic examination was done, vaginal discharge /secretions were collected with an ayre spatula from the posterior fornix for gram staining, culture and sensitivity. Midstream urine sample collected for culture and sensitivity. Microbiological analysis and antimicrobial sensitivity testing of urine and vaginal swab done in the Department of Microbiology at the Institute. The Women of gestational age of 28-37 weeks reporting to OPD for regular ANC Checkups without any symptoms were taken as control group (GROUP B) and sample collected for the study by the similar procedure and compared statistically. Positive high vaginal swab and Urinary culture was seen in 77% Results: and 65% of the case group respectively compared to control group. The average age of presentation was 21-25years and most of the women were primigravidae in either group i.e 43% and 37% respectively. Previous history of preterm labour was present in only 10% of case group. Commonest microorganism isolated in high vaginal swab was coagulase negative staphylococcus(33.8%) and in urine culture was E coli (21.5%) were sensitive to ceftriaxone, cefotaxime and nitrofurantoin and ceftriaxone respectively. Vaginal infection was1.5 times and Urin Conclusion: ary infection was 2.6 times in preterm women compared to control in our study. This signies the need of screening of women during antenatal checkup for the genitourinary infections, which allow us to pick up even asymptomatic cases. Making early diagnosis and treating them adequately with the antimicrobials i.e cephalosporins and nitrofurantoin in our setup will go a long way in decreasing the incidence of preterm labor, preterm births, and the associated neonatal and maternal morbidities.