A Longitudinal Study Of Bacterial Vaginosis During Pregnancy Based On The Hospital

Objective To investigate the status, longitudinal change and influence factors of bacterial vaginosis during pregnancy to provide the basis for pregnant women and related departments to make the intervention measures.Methods The pregnant women who sought the prenatal care in Maternal and Child Health Care Hospital of Maanshan during the first trimester of pregnancy from September to December 2012 were choosed. These pregnant women would accept the gynecological examination for the first time to collect the vaginal secretions according to the inclusion and exclusion standards. Then, the vaginal secretions were used to diagnosis the bacterial vaginosis, trichomoniasis and candidiasis by laboratory inspection. The participants would accept the second and third investigation when they sought the prenatal care during the second and third trimester of pregnancy. In addition, the questionnaire survey was conducted which mainly included the sociodemographic characteristics, living habit, the status of pregnancy, history of pregnancy and procreation, and the complication during pregnancy. Finally, 793 pregnant women who accepted the first and second investigation at least were used to analysis in this article. Among these women, 761 completed all three visits, so the data of these 761 women were used to describe the prevalence and longitudinal change of bacterial vaginosis during pregnancy. Finally, among the 793 pregnant women, the data of 668 women were used to identify the influence factor of bacterial vaginosis during pregnancy by Cox regression after excluding the women who were BV positive at baseline visit.Results The detection rate of bacterial vaginosis was 15.9%, 17.7% and 15.2%, respectively. The trend of negative at all 3 time points(61.2%) was dominant compared with trend of positive throughout pregnancy(1.1%) was the most rare. The trend toward negative(12.6%), trend toward positive(12.0%) and random status(13.1%) was similar. In the multivariable model, compared with the women whose husbands had junior school or lower education, husbands had high school or technical school education was a protective factor for bacterial vaginosis(HR: 0.50; 95%CI: 0.32-0.77, P=0.002), but changing underwear nearly everyday(HR: 1.87; 95%CI: 1.26-2.77, P=0.002), miscarriage history(HR: 2.96; 95%CI: 1.96-4.47, P=0.000), urinary tract infection during follow-up(HR: 2.41; 95%CI: 1.05-5.49, P=0.037), and concurrent trichomoniasis(HR: 1.82; 95%CI: 1.02-3.25, P=0.042) and candidiasis(HR: 1.88; 95%CI: 1.30-2.70, P=0.001) were the risk factors for bacterial vaginosis.Conclusion The detection rate of bacterial vaginosis during the different trimesters of pregnancy was similar and in the intermediate level. The trend of over half of pregnant women was negative at all 3 time points and only a handful of pregnant women were positive throughout pregnancy; the trend toward negative and positive was similar, and the random status can not be ignored. From the point of longitudinal developmen, husbands’ education level, changing underwear nearly everyday, miscarriage history, urinary tract infection during follow-up, and concurrent trichomoniasis and candidiasis were associated with bacterial vaginosis, so the related departments should formulate the comprehensive prevention and control measures to help pregnant women to prevent bacterial vaginosis and promote reproductive health during pregnancy.