The Effects of Symptomatic Bacterial Vaginosis in the Second Trimester of Pregnancy on Pregnancy Outcome

Bacterial Vaginosis and Pregnancy Outcome

Authors

  • İlkan Kayar Deparment of Obstetric and Gynecology, Osmaniye State Hospital, Osmaniye, Turkey.
  • Ferhat Çetin Deparment of Obstetric and Gynecology, Osmaniye State Hospital, Osmaniye, Turkey.
  • Özer Birge Deparment of Obstetric and Gynecology, Osmaniye State Hospital, Osmaniye, Turkey.
  • Cüneyt Eftal Taner Izmir Aegean Obstetrics and Gynecology Research and Training Hospital, Izmir, Turkey.

DOI:

https://doi.org/10.1071/ejmbs.v5i1.41

Keywords:

Bacterial vaginosis, premature rupture, preterm delivery, second trimester

Abstract

A prospective cohort study was designed to evaluate the correlation between the presence of bacterial vaginosis and pregnancy outcomes. 192 pregnant women in the second trimester of pregnancy with vaginal discharge were included in the study.The study group consisted of 50 pregnant women positive for the presence of bacterial vaginosis. 138 pregnant women without bacterial vaginosis constituted the control group and both groups were compared in respect to the pregnancy outcomes. Neither the timing of the delivery nor the presence of chorioamnionitis, wound infections or postpartum endometritis showed a statistically significant difference between the groups (p > 0.05). The incidences of both preterm labor and premature rupture of membranes were found to be significantly higher in the group of patients with bacterial vaginosis (p <0.05). The presence of bacterial vaginosis in the second trimester of pregnancy increases the rates of premature rupture of membranes as well as preterm labor. Other complications of pregnancy exhibited a somewhat similar increase in number however these figures were statistically insufficient to prove a significant correlation inbetween. We suppose that a new study group of a substantially larger scale will demonstrate a significant increase in these complications as well.

References

Bhakta V, Aslam S, Aljaghwani A. Bacterial vaginosis in pregnancy: prevalence and outcomes in a tertiary care hospital. Afr J Reprod Health. 2021 Feb;25(1):49-55.

Bothuyne-Queste E, Hannebicque-Montaigne K, Canis F, Noulard MN, Plennevaux JL, Tilloy E, Subtil D. 2012. Is the bacterial vaginosis risk factor of prematurity? Study of a cohort of 1336 patients in the hospital of Arras. J Gynecol Obstet Biol Reprod 41(3):262-270.

Brocklehurst P1, Gordon A, Heatley E, Milan SJ. 2013. Antibiotics for treating bacterial vaginosis in pregnancy. Cochrane Database Syst Rev 31:1

Flynn CA, Helwig AL, Meurer LN. 1999. Bacterial vaginosis in pregnancy and the risk of prematurity: a meta-analysis. J Fam Pract 48(11):885-892.

Guerra B, Ghi T, Quarta S, Morselli-Labate AM, Lazzarotto T, Pilu G, Rizzo N. 2006. Pregnancy outcome after early detection of bacterial vaginosis. Eur J Obstet Gynecol Reprod Biol 128(1-2):40-45.

Hoffmann E, Váncsa S, Váradi A, Hegyi P, Nagy R, Hamar B, Futács V, Kepkep B, Nyirády P, Demendi C, Ács N. Routine screening of abnormal vaginal flora during pregnancy reduces the odds of preterm birth: a systematic review and meta-analysis. Sci Rep. 2023 Aug 25;13(1):13897.

Jacobsson B, Pernevi P, Chidekel L, Platz-Christensen JJ. 2002. Bacterial vaginosis in early pregnancy may predispose for preterm birth and postpartum endometritis. Acta Obstet Gynecol Scand 81:1006–1010.

Klebanoff MA, Schuit E, Lamont RF, Larsson PG, Odendaal HJ, Ugwumadu A, Kiss H, Petricevic L, Andrews WW, Hoffman MK, Shennan A, Seed PT, Goldenberg RL, Emel LM, Bhandaru V, Weiner S, Larsen MD. Antibiotic treatment of bacterial vaginosis to prevent preterm delivery: Systematic review and individual participant data meta-analysis. Paediatr Perinat Epidemiol. 2023 Mar;37(3):239-251.

Leitich H, Bodner-Adler B, Brunbauer M, Kaider A, Egarter C, Husslein P. 2003. Bacterial vaginosis as risk factor for preterm delivery: a meta-analysis. Am J Obstet Gynecol 189(1):139-147.

Martius J, Eschenbach DA. 1990. The role of bacterial vaginosis as a cause of amniotic fluid infection, chorioamnionitis and prematurty-A rewiew. Arch Gynecol Obstet 247:1-13.

McGregor JA, French JI. 2000. Bacterial vaginosis in pregnancy. Obstet Gynecol Surv 55:1–19.

Menard JP, Bretelle F. 2012. Bacterial vaginosis and preterm delivery. Gynecol Obstet Fertil. 40(1):48-54.

Mu Y, Hu A, Kan H, Li Y, He Y, Fan W, Liu H, Li Q, Zheng Y. Preterm Prelabor Rupture of Membranes Linked to Vaginal Bacteriome of Pregnant Females in the Early Second Trimester: a Case-Cohort Design. Reprod Sci. 2023 Jul;30(7):2324-2335.

Ng BK, Chuah JN, Cheah FC, Mohamed Ismail NA, Tan GC, Wong KK, Lim PS. Maternal and fetal outcomes of pregnant women with bacterial vaginosis. Front Surg. 2023 Feb 13;10:1084867.

Nugent RP, Krohn MA, Hillier SL. 1991. Reliability of diagnosing bacterial vaginosis is improved by a standized method of gram stain interpretation. Journal of Clinical Microbiology 29(2):297-301.

Nygren P, Fu R, Freeman M, Bougatsos C, Klebanoff M, Guise JM. 2008. Evidence on the benefits and harms of screening and treating pregnant woman who are asymptomatic for bacterial vaginosis:an update review for the U.S. Preventive Services Task Force. Ann Intern Med 148(3):220-233.

Oakeshott P, Kerry S, Hay S, Hay P. 2004. Bacterial vaginosis and preterm birth: a prospective community-based cohort study. Br J Gen Pract 54:119–122.

Obata-Yasuoka M, Ba-Thein W, Hamada H, Hayashi H. 2002. A multiplex polymerase chain reaction-based diagnostic method for bacterial vaginosis 2002. Obstet Gynecol 100(4):759-764.

Oliver RS, Lamont RF. 2013. Infection and antibiotics in the aetiology, prediction and prevention of preterm birth. J Obstet Gynaecol. 33(8):768-775.

Riduan JM, Hillier SL, Utomo B, Wiknjosastro G, Linnan M, Kandun N. 1993. Bacterial vaginosis and prematurity in Indonesia:association in early and late pregnancy. Am J Obstet Gynecol 169:175–178.

Sethi N, Narayanan V, Saaid R, Ahmad Adlan AS, Ngoi ST, Teh CSJ, Hamidi M; WHOW research group. Prevalence, risk factors, and adverse outcomes of bacterial vaginosis among pregnant women: a systematic review. BMC Pregnancy Childbirth. 2025 Jan 20;25(1):40.

Sha BE, Chen HY, Wang QJ, Zariffard MR, Cohen MH, Spear GT. 2005. Utility of Amsel criteria,Nugent score and quantitative PCR for Gardnerella vaginalis, Mycoplasma hominis and Lactobacillus spp. for diagnosis of bacterial vaginosis in human immunodeficiency virus-infected women. J Clin Microbiol 43(9):4607-4612.

Svare JA, Schmidt H, Hansen BB, Lose G. 2006. Bacterial vaginosis in a cohort of Danish pregnant women : prevalence and relationship with preterm delivery, low birthweight and perinatal infections. BJOG 113(12):1419-1425.

Tam MT, Yungbluth M, Myles T. 1998. Gram stain method shows better sensitivity than clinical criteria for detection of bacterial vaginosis in survaillance of pregnant, of pregnant, low-income women in a clinical setting. Infect Dis Obstet Gynecol 6(5):204-208.

Thorsen P, Vogel I, Olsen J, Jeune B, Westergaard JG, Jacobsson B, Moller BR. 2006. Bacterial vaginosis in early pregnancy is associated with low birthweight and small for gestational age, but not with spontaneous preterm birth: a population-based study on Danish women. J Matern Fetal Neonatal Med 19:1–7.

Yefet E, Mirin D, Massalha M, Alter A, Nachum Z. Screening for and Treatment of Bacterial Vaginosis Reduced Preterm Delivery in High-Risk Pregnant Women: A Systematic Review and Meta-Analysis. Gynecol Obstet Invest. 2025 Jan 22:1-10.

Watts DH, Krohn MA, Hillier SL, Eschenbach DA. 1990. Bacterial vaginosis as a risk factor for post-cesarean endometritis. Obstet Gynecol 75:52–58.

Wu J, Zhu X, Tang B, Wu J, Wei F, Wang X, Li L, Li H, Zhang Y, Wang B, Wu W, Hong X. Effects of bacterial vaginosis treatment during pregnancy on maternal-fetal outcome: A systematic review and network meta-analysis. Eur J Obstet Gynecol Reprod Biol. 2025 Apr;307:175-183.

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Published

2025-08-08

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Section

Medical Science