THE GENITAL FLORA OF WOMEN WITH INTRAAMNIOTIC INFECTION

The relationship of genital flora assessed at the end of the second tr imester of pregnancy and intraamniotic infection diagnosed by clinical signs and symptoms during labor was evaluated. Women were enrolled at 23-26 weeks of gestation and followed through delivery in the multice nter Vaginal Infections and Prematurity Study (1984-1989). Among the c ohort of 11,989 followed through delivery, 286 (2.4%) developed intraa mniotic infection. The recovery of Gardnerella vaginalis (relative ris k [RR] = 1.8; 95% confidence interval [CI] = 1.4-2.4), heavy growth of Bacteroides species (RR = 1.5; 95% CI = 1.1-2.1), and isolation of My coplasma hominis (RR = 1.7; 95% CI = 1.3-2.1) from the vagina at the e nd of the second trimester of pregnancy were associated with an increa sed risk of intraamniotic infection. Bacterial vaginosis was also asso ciated with intraamniotic infection (RR = 1.5; 95% CI = 1.1-2.2). Thes e findings extend prior studies by showing that prenatal cultures for microorganisms associated with bacterial vaginosis predicted an increa sed risk of intraamniotic infection.