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Year : 2021  |  Volume : 6  |  Issue : 1  |  Page : 33-40

Impact of treatment and the contribution of persistent posttreatment bacterial vaginosis infection on pregnancy outcome among asymptomatic women: A cohort study

1 Bridge Clinic, Lagos, Nigeria
2 Department of Obstetrics & Gynaecology, University of Cape Town, Observatory, Cape Town, South Africa
3 Department of Medical Microbiology and Parasitology, University of Ilorin, Ilorin, Nigeria

Correspondence Address:
Babatunde D Ogunniran
Bridge Clinic, 66, Oduduwa Way, G.R.A., Ikeja, Lagos,
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/liuj.liuj_49_20

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Objective: The objective of this study was to evaluate the effect of antibiotic treatment and posttreatment persistent bacterial vaginosis (BV) infection on pregnancy outcome among asymptomatic women. Materials and Methods: A prospective cohort study was conducted among consenting, asymptomatic pregnant women without background medical disorders. All participants were recruited in the second trimester and had BV testing using Nugent score. BV-positive women were treated with a 7-day course of metronidazole with a repeat posttreatment laboratory testing after 4 weeks. The primary outcome was pregnancy outcome of BV-positive versus negative women; the secondary outcomes were posttreatment laboratory BV test result and pregnancy outcome among women with resolution versus persistent infection. Data analysis was performed using SPSS version 21.0 and P < 0.05 was significant. Results: The prevalence of BV in pregnancy was 24.1%; vulva itching and vaginal douching were more common among BV-positive women (P = 0.011 and P = 0.001), respectively. Adverse pregnancy outcomes such as premature rupture of membranes (PROM) (odds ratio [OR]: 8.185, 95% confidence interval [CI]: 3.196–20.962; P = 0.005), preterm delivery (OR: 24.517, 95% CI: 6.985–86.049; P = 0.001), and birth weight <2500 g (OR: 6.460, 95% CI: 2.893–14.429; P = 0.005) were more common among BV-positive women. Posttreatment persistent BV infection was 25.0% with significantly higher PROM (OR: 18.21, 95% CI: 4.654–71.317; P = 0.001), preterm delivery (OR: 14.571, 95% CI: 4.138–51.308; P = 0.001), birth weight <2500 g (OR: 14.57, 95% CI: 4.138–51.308; P = 0.001), and low 1st min Apgar scores (OR: 7.333, 95% CI: 1.223–43.960; P = 0.049). Conclusion: Symptom-based approach to BV in pregnancy excludes many asymptomatic women; we hereby recommend routine screening. Also, women with BV in pregnancy should undergo repeat testing posttreatment while those with persistent infection will benefit from repeat treatment pending further evidence to formulate a widely acceptable treatment guideline.

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