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Extraction was from original data files. Bias risk was assessed using the Cochrane tool. Analysis used \u201cone\u2010step\u201d logistic and Cox random effect models, adjusting gestation at randomisation and PTD history; heterogeneity by <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>. Subgroup analysis tested interactions with treatment. In sensitivity analyses, studies not providing IPD were incorporated by \u201cmultiple random\u2010donor hot\u2010deck\u201d imputation, using IPD studies as donors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 121 references (96 studies) with 23 eligible trials (11,979 participants); 13 studies (6915 participants) provided IPD; 12 (6115) were incorporated. Results from 9 (4887 participants) not providing IPD were imputed. Odds ratios for PTD for metronidazole and clindamycin versus placebo were 1.00 (95% CI 0.84, 1.17), <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u200962%, and 0.59 (95% CI 0.42, 0.82), <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u20090 before; and 0.95 (95% CI 0.81, 1.11), <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u200959%, and 0.90 (95% CI: 0.72, 1.12), <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u20090, after imputation. Time\u2010to\u2010delivery did not differ from null with either treatment. Including imputed IPD, there was no evidence that either drug was more effective when administered earlier, or among those with a PTD history.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Clindamycin, but not metronidazole, was beneficial in studies providing IPD, but after imputing data from missing IPD studies, treatment of BV during pregnancy did not reduce PTD, nor prolong pregnancy, in any subgroup or when started earlier in gestation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ppe.12947","type":"journal-article","created":{"date-parts":[[2023,1,18]],"date-time":"2023-01-18T12:44:39Z","timestamp":1674045879000},"page":"239-251","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["Antibiotic treatment of bacterial vaginosis to prevent preterm delivery: Systematic review and individual participant data 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