The Relationship of Between Bacterial Genital Infections in Pregnancy Outcomes in 2000-2018: A Systematic Review and Meta-Analysis

Background: Bacterial infections represent one of the most serious infections in the world, which may bring about consequences such as miscarriage, premature birth, stillbirth, and ectopic pregnancy in pregnant women. The aim of this study was to investigate the relationship between bacterial infections and pregnancy outcomes through a meta-analysis. Methods: The present study was a systematic review and meta-analysis of international databases (PubMed, Scopus, Web of Science, Embase, and Ovid) to find case control and cohort studies between 2000 and 2018. Each process of screening, selection, data extraction and risk of bias done by two researchers, individually. The risk of bias was assessed by the Newcastle-Ottawa Scale (NOS). The pooled odds ratio (OR) in case control studies and risk ratio (RR) in cohort studies were calculated through random effect model approach. Results: After the pooled of cohort studies, the results of analysis showed that the risk ratio of preterm delivery in pregnant women with vaginal infections is 1.57 (% 95 CI; 1.46 - 1.67), while the risk ratio of abortion is 2.02 (% 95 CI; 1.72 to 2.38). After the pooled of case control studies, the odds ratio of ectopic pregnancy in pregnant women with vaginal infections, 1.12 times more likely than pregnant women without such infections (OR: 1.12; % 95 CI; 1.05 – 1.19) to develop ectopic pregnancy. Discussion: Bacterial infections increase risk outcomes of pregnancy such as miscarriage, premature birth, ectopic pregnancy and stillbirth, giving rise to unimaginable and irreparable complications in the fetus with enormous economic costs. A key measure to reduce or prevent the adverse outcomes of genital infections is to monitor and screen pregnant women regularly to detect these infections. Funding: Funding provided by Kurdistan University of Medical Sciences. Declaration of Interest: This study doesn't include any conflict of interest for the authors. Ethical Approval: The study protocol was approved by the Ethics Committee of Kurdistan University of Medical Sciences. The approval number is: IR.MUK.REC.1397.317.