{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T20:52:58Z","timestamp":1791924778322,"version":"4.3.4"},"reference-count":55,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2016,6,23]],"date-time":"2016-06-23T00:00:00Z","timestamp":1466640000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2016,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Bacterial vaginosis (<jats:styled-content style=\"fixed-case\">BV<\/jats:styled-content>) is characterized by a dysbiosis of the vaginal microbiota with a depletion of <jats:italic>Lactobacillus<\/jats:italic> spp. In pregnancy, prevalence's between 7 and 30% have been reported depending on the study population and the definition. <jats:styled-content style=\"fixed-case\">BV<\/jats:styled-content> may be associated with an increased risk of spontaneous preterm delivery (<jats:styled-content style=\"fixed-case\">sPTD<\/jats:styled-content>). However, it is controversial whether or not <jats:styled-content style=\"fixed-case\">BV<\/jats:styled-content>\u2010positive pregnant women will benefit from treatment to reduce the risk of <jats:styled-content style=\"fixed-case\">sPTD<\/jats:styled-content>. We could not identify any good\u2010quality guideline addressing this issue. Consequently we aimed to produce this clinical recommendation based on GRADE.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>Systematic literature searches were conducted in the following databases: Guidelines International Network: G\u2010I\u2010N, Medline, Embase, The Cochrane Database of Systematic Reviews, Web of Science and <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/www.clinicaltrials.gov\">http:\/\/www.clinicaltrials.gov<\/jats:ext-link> from 1999 to 3 October 2014. Hence, nine guidelines, 34 reviews, 18 randomized controlled trials and 12 observational studies were included.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The <jats:styled-content style=\"fixed-case\">GRADE<\/jats:styled-content> quality of evidence was consistently low or very low, primarily because none of the risk ratios (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content>) for the risk of <jats:styled-content style=\"fixed-case\">sPTD<\/jats:styled-content> at &lt;37 weeks were statistically significant. Concerning treatment with metronidazole, <jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content> was 1.11 (95% CI 0.93\u20131.34) in low\u2010risk pregnancies and 0.96 (95% CI 0.78\u20131.18) in high risk pregnancies. Concerning treatment with clindamycin at any gestational age, the <jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content> was 0.87 (95% CI 0.73\u20131.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This systematic review gives a strong recommendation against treatment with metronidazole and a weak recommendation against treatment with clindamycin to reduce the <jats:styled-content style=\"fixed-case\">sPTD<\/jats:styled-content> rate in both high\u2010risk and low\u2010risk pregnancies with <jats:styled-content style=\"fixed-case\">BV<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.12933","type":"journal-article","created":{"date-parts":[[2016,6,3]],"date-time":"2016-06-03T14:29:45Z","timestamp":1464964185000},"page":"850-860","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":67,"title":["Treatment of bacterial vaginosis in pregnancy in order to reduce the risk of 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