Acquisition and elimination of bacterial vaginosis during pregnancy: a Danish population-based study

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  • Ida Vogel
  • Poul Thorsen, Denmark
  • Bernard Jeune, Denmark
  • Bo Jacobsson, Perinatal Center, Department of Obstetrics and Gynecology, Sahlgrenska Academy, Göteborg University, Denmark
  • Niels Ebbesen, Denmark
  • Magnus Arpi, Denmark
  • Annie Bremmelgaard, Denmark
  • Birger R Møller, Denmark
  • Institute of Epidemiology and Social Medicine
  • Department for Clinical Genetics
OBJECTIVES: the aim was to examine factors associated with acquisition and elimination of bacterial vaginosis in pregnancy. METHODS: a group of 229 pregnant women were randomly selected from a population-based prospective cohort study of 2927. They were examined at enrollment (mean gestational weeks 16w+0d) and again in mid-third trimester (mean gestational age 32w+3d). MEASURES: BV (Amsel's clinical criteria), microbiological cultures of the genital tract and questionnaire data. RESULTS: BV prevalence decreased from 17% in early second trimester to 14% in mid-third trimester due to a tenfold higher elimination rate (39%) than incidence rate (4%). Heavy smokers (>10/d) in early pregnancy were at increased risk (5.3[1.1-25]) for the acquisition of BV during pregnancy, as were women receiving public benefits (4.8[1.0-22]), having a vaginal pH above 4.5(6.3[1.4-29]) or vaginal anaerobe bacteria (18[2.7-122]) at enrollment. A previous use of combined oral contraceptives was preventive for the acquisition of BV (0.2[0.03-0.96]). Elimination of BV in pregnancy tended to be associated with a heavy growth of Lactobacillus(3.2[0.8-13]) at enrollment. CONCLUSIONS: acquisition of BV during pregnancy is rare and is associated with smoking, while the presence of anaerobe bacteria and a vaginal pH >4.5 are interpreted as steps on a gradual change towards BV. In the same way heavy growth of Lactobacillus spp in early pregnancy may be an indicator of women on the way to eliminate BV.
Original languageEnglish
Article number94646
JournalInfectious Diseases in Obstetrics and Gynecology
Volume2006
Number of pages7
ISSN1064-7449
DOIs
Publication statusPublished - 2006

    Research areas

  • Bacteria, Anaerobic, Cohort Studies, Denmark, Female, Humans, Hydrogen-Ion Concentration, Incidence, Lactobacillus, Pregnancy, Pregnancy Complications, Infectious, Pregnancy Trimester, Second, Pregnancy Trimester, Third, Prevalence, Risk Factors, Smoking, Vaginosis, Bacterial

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