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Journal of Clinical Microbiology, March 2003, p. 1073-1079, Vol. 41, No. 3
0095-1137/03/$08.00+0     DOI: 10.1128/JCM.41.3.1073-1079.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.

Quantitative Microbiologic Models for Preterm Delivery

Andrew B. Onderdonk,* Mei-Ling Lee, Ellice Lieberman, Mary L. Delaney, and Ruth E. Tuomala

Channing Laboratory, Departments of Pathology and Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts

Received 20 August 2002/ Returned for modification 8 October 2002/ Accepted 26 November 2002

Preterm delivery (PTD) is the leading cause of infant morbidity and mortality in the United States. An epidemiological association between PTD and various bacteria that are part of the vaginal microflora has been reported. No single bacterial species has been identified as being causally associated with PTD, suggesting a multifactorial etiology. Quantitative microbiologic cultures have been used previously to define normal vaginal microflora in a predictive model. These techniques have been applied to vaginal swab cultures from pregnant women in an effort to develop predictive microbiologic models for PTD. Logistic regression analysis with microbiologic information was performed for various risk groups, and the probability of a PTD was calculated for each subject. Four predictive models were generated by using the quantitative microbiologic data. The area under the curve (AUC) for the receiver operating curves ranged from 0.74 to 0.94, with confidence intervals (CI) ranging from 0.62 to 1. The model for the previous PTD risk group with the highest percentage of PTDs had an AUC of 0.91 (CI, 0.79 to 1). It may be possible to predict PTD by using microbiologic risk factors measured once the gestation period has reached the 20-week time point.

* Corresponding author. Mailing address: Channing Laboratory, 181 Longwood Ave., Boston, MA 02115. Phone: (617) 525-2506. Fax: (617) 731-1541. E-mail: aonderdonk{at}partners.org.

Journal of Clinical Microbiology, March 2003, p. 1073-1079, Vol. 41, No. 3
0095-1137/03/$08.00+0     DOI: 10.1128/JCM.41.3.1073-1079.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.



This article has been cited by other articles:

  • Ferris, M. J., Norori, J., Zozaya-Hinchliffe, M., Martin, D. H. (2007). Cultivation-Independent Analysis of Changes in Bacterial Vaginosis Flora Following Metronidazole Treatment. J. Clin. Microbiol. 45: 1016-1018 [Abstract] [Full Text]  
  • Wilks, M., Wiggins, R., Whiley, A., Hennessy, E., Warwick, S., Porter, H., Corfield, A., Millar, M. (2004). Identification and H2O2 Production of Vaginal Lactobacilli from Pregnant Women at High Risk of Preterm Birth and Relation with Outcome. J. Clin. Microbiol. 42: 713-717 [Abstract] [Full Text]  


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