Ishaque et al. BMC Public Health 2011, 11(Suppl 3):S3 http://www.biomedcentral.com/1471-2458/11/S3/S3 Page 6 of 12 Treatment Control Peto Odds Ratio Events Total Events Total Weight Peto, Fixed, 95% CI Peto Odds Ratio Peto, Fixed, 95% CI Study or Subgroup 5.1.1 Oral antibiotics McDonald 1997 NICHD MFMU 2000 Odendaal 2002 Subtotal (95% CI) 1 13 8 242 952 136 1330 1 208 208 Total events 22 23 Heterogeneity: Chi² = 3.29, df = 2 (P = 0.19); I² = 39% Test for overall effect: Z = 0.14 (P = 0.89) 5.1.2 Vaginal antibiotics Lamont 2003 Subtotal (95% CI) Total events 1 Heterogeneity: Not applicable Test for overall effect: Z = 1.04 (P = 0.30) 1 238 4.2% 19 965 65.5% 3 133 22.0% 1336 91.7% 0.98 [0.06, 15.77] 0.69 [0.34, 1.39] 2.51 [0.75, 8.38] 0.96 [0.53, 1.73] 3 201 201 3 8.3% 8.3% 0.35 [0.05, 2.52] 0.35 [0.05, 2.52] Total (95% CI) 1538 1537 100.0% 0.88 [0.50, 1.55] Total events 23 26 Heterogeneity: Chi² = 4.20, df = 3 (P = 0.24); I² = 29% Test for overall effect: Z = 0.43 (P = 0.67) Test for subgroup differences: Chi² = 0.91, df = 1 (P = 0.34), I² = 0% 0.01 0.1 1 10 100 Favours experimental Favours control Figure 4 Treatment of bacterial vaginosis in pregnancy: Any antibiotic versus placebo/no Outcome: Perinatal death. and no losses in the treated group, but the results were non-significant (P = 0.12) [45]. A meta-analysis on peri- odontal care during pregnancy versus treatment after birth based on two studies [13,45] has shown a 70% sig- nificant reduction in stillbirth (RR = 0.30; 95% CI: 0.12 – 0.76) (Philippa Middleton, personal communication). Helminthiasis A recent study from Uganda on deworming during pregnancy has shown no effect of treatment with alben- dazole or praziquantel on incidence of stillbirths com- pared to placebo [46]. Another open label, randomized controlled trial from Uganda that compared ivermectin, albendazole, combined ivermectin/albendazole com- pared with placebo showed similar results (P = 0.13) [47]. The Cochrane review by Haider et al. reported the pooled effect of use of anti-helminthic therapy on peri- natal mortality based on two RCTs [48,49] and showed no overall effect (RR = 1.10; 95% CI: 0.55 – 2.22). TORCH INFECTION: TOXOPLASMOSIS, OTHER (SYPHILIS, VARICELLA-ZOSTER, PARVOVIRUS B19), RUBELLA, CYTOMEGALOVIRUS (CMV), AND HERPES INFECTIONS A case control study from Jordan reports that the pre- sence of Toxoplasmosis gondii was significantly higher in those with adverse pregnancy outcomes compared to controls (54% vs. 12%, p<0.02) [50] Maternal rubella has been implicated as a cause of stillbirths [51]. In Guinea-Bissau, stillbirth rates were increased 4- to 9-fold if the mother was infected with rubella during her pregnancy [3]. Cytomegalovirus A study from Australia [52] reported that 9% of blood samples taken from stillbirths by cardiac puncture were PCR positive for CMV. A recent study from Greece using PCR, showed significantly increased levels of CMV (16%) in the placentas of stillbirths compared to controls (3%) [53].