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Re: Asymptomatic bacteriuriaFrom: Braun, R. Daniel (rbraun@iupui.edu)Fri Apr 21 09:46:10 2000
This is the artticle you referred to, I believe?? If so it does not contradict what I said. Nor does it verify what I said. It makes no mention of the incidence of pyelonephritis and whether or not it occurred in those who dleivered preterm. Dan Meta-analysis of the relationship between asymptomatic bacteriuria and preterm delivery/low birth weight. Obstet Gynecol 1989 Apr;73(4):576-82 (ISSN: 0029-7844) Romero R; Oyarzun E; Mazor M; Sirtori M; Hobbins JC; Bracken M [Find other articles with these Authors] Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, Connecticut. The relationship between asymptomatic bacteriuria and prematurity/low birth weight (LBW) is still a controversial issue, despite many studies. Meta-analysis, a research tool designed to analyze and combine the results of previous studies, may resolve this discrepancy among contradictory results of clinical trials. The purpose of this study was to examine the relationship between asymptomatic bacteriuria and preterm delivery/LBW using meta-analysis. Reports from the literature were classified according to study design into cohort or randomized-treatment control trials. Meta-analysis of cohort studies showed that untreated asymptomatic bacteriuria during pregnancy significantly increased rates of LBW and preterm delivery. Nonbacteriuric patients had only about two-thirds the risk (typical relative risk = 0.65; 95% confidence interval 0.57, 0.74) of LBW and half the risk (typical relative risk = 0.50; 95% confidence interval 0.36, 0.70) of preterm delivery of those with untreated asymptomatic bacteriuria. These reduced risks correspond to a 3.4 (confidence interval 1.8, 5.0) percentage-point difference in LBW and a 3.8 (1.1, 6.4) percentage-point difference in preterm delivery. The analysis of randomized clinical trials showed that antibiotic treatment significantly reduced the risk of LBW (typical relative risk = 0.56; 95% confidence interval 0.43, 0.73), with a substantial reduction of 6.4 (confidence interval 3.3, 9.5) percentage points in the rate of LBW. We conclude that clinical and epidemiologic evidence indicates a strong association between untreated asymptomatic bacteriuria and LBW/preterm delivery and that antibiotic treatment is effective in reducing the occurrence of LBW. R. Daniel Braun, MD FACOG Clinical Professor Department of Obstetrics and Gynecology Indiana U. School of Medicine Indianapolis, IN 46202 OBGYN.net International Representative for United States Certified AllExperts Expert Check out my bio/ratings page! http://www.allexperts.com/displayExpert.asp?Expert=1236 -----Original Message----- From: eramirez@icepr.com [mailto:eramirez@icepr.com] Sent: Thursday, April 20, 2000 5:25 PM To: Multiple recipients of list OB-GYN-L Subject: Re: Asymptomatic bacteriuria Or chorio - there is a good article by Romero in the Green -- "META-ANALYSIS OF THE RELATIONSHIP BETWEEN ASYMPTOMATIC BACTERIURIA AND PRETERM DELIVERY/LOW BIRTH WEIGHT" I am very agressive with ASB - maybe I overtreat some patients -
At Thu, 20 Apr 2000, Braun, R. Daniel wrote:
>
-- "The things you learn after you know everything are the important ones"
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