The Role of Bacterial Vaginosis and Vaginal Bacteria in Amniotic Fluid Infection in Women in Preterm Labor with Intact Fetal Membranes

Amniotic fluid infection, which is defined by the presence of microorganisms in the amniotic fluid, is associated with preterm birth and poor neonatal outcome, including neonatal sepsis, respiratory distress syndrome, bronchopulmonary dysplasia, low birth weight, and neonatal death. Amniotic fluid infection is common among women in preterm labor. The frequency of positive amniotic fluid cultures among women presenting in preterm labor with intact fetal membranes has ranged from 4% to 26. The microbiological risk factors for amniotic fluid infection in women with intact fetal membranes have not been well described. Bacterial vaginosis has been associated with subclinical amniotic fluid infection in women with intact fetal membranes. While amniotic fluid infection is believed to be caused by the ascension of microorganisms from the lower genital tract, concurrent vaginal and amniotic fluid cultures have not been performed to ascertain whether microorganisms recovered from the amniotic fluid can also be detected in the lower genital tract. The purpose of this study was to evaluate the association between vaginal microorganisms and amniotic fluid infection and to evaluate the hypothesis that amniotic fluid infection is an ascending infection.