From the Epidemiology Branch A3-05, National Institute of Environmental Health Sciences, Research Triangle Park, NC.
Femeris Women's Health Research Center, Medical Diagnostic Laboratories, A Division of Genesis Biotechnology Group, Hamilton, NJ.
Sex Transm Dis. 2021 Nov 1;48(11):844-850. doi: 10.1097/OLQ.0000000000001466.
Reproductive tract infections are hypothesized to influence uterine fibroid development, yet few studies have investigated the common condition of bacterial vaginosis (BV). The literature is currently limited to data using self-report of BV.
We conducted a nested case-control study of 200 women (100 cases and 100 controls) from a large study of 23- to 35-year-old African American women, 1310 of whom were fibroid-free and prospectively followed up for 5 years to identify incident fibroids with standardized ultrasound examinations. We used quantitative polymerase chain reaction, an objective molecular method, to assess 9 BV-associated and 4 Lactobacillus species from vaginal swab specimens. We used hierarchical logistic regression to compute odds ratios and 95% confidence intervals to examine associations between bacterial species (both individually and grouped as (1) "optimal" Lactobacillus and (2) BV-associated species) with fibroid incidence and number. We also examined vaginal imbalance (quantitatively more BV-associated bacteria than optimal Lactobacilli).
Contrary to our hypothesis, we found no increase in fibroid incidence or number among women with more BV-associated bacteria. High imbalance (only BV-associated bacteria, no optimal Lactobacillus bacteria) was actually inversely associated with fibroid incidence (odds ratio, 0.38; 95% confidence interval, 0.17-0.81).
This is the first study of ultrasound-detected incident fibroids and molecular vaginal bacterial assessment. We found no evidence that BV-associated bacteria increase the risk of fibroid incidence or number.
生殖道感染被认为会影响子宫肌瘤的发展，但很少有研究调查细菌性阴道病（BV）这一常见病症。目前，该文献仅限于使用 BV 自我报告的数据。
我们对来自一项针对 23 至 35 岁非裔美国女性的大型研究的 200 名女性（100 例病例和 100 名对照）进行了嵌套病例对照研究，其中 1310 名女性没有子宫肌瘤，并前瞻性随访 5 年以使用标准超声检查确定新发生的子宫肌瘤。我们使用定量聚合酶链反应（一种客观的分子方法）从阴道拭子标本中评估了 9 种与 BV 相关的细菌和 4 种乳杆菌属。我们使用分层逻辑回归计算优势比和 95%置信区间，以检查细菌种类（单独和分组为 (1) “最佳”乳杆菌和 (2) 与 BV 相关的细菌）与子宫肌瘤发生率和数量之间的关联。我们还检查了阴道失衡（定量上 BV 相关细菌多于最佳乳杆菌）。
与我们的假设相反，我们没有发现 BV 相关细菌较多的女性子宫肌瘤发生率或数量增加。高失衡（只有 BV 相关细菌，没有最佳乳杆菌细菌）实际上与子宫肌瘤的发生率呈负相关（优势比，0.38；95%置信区间，0.17-0.81）。
这是第一项使用超声检测到的新发性子宫肌瘤和分子阴道细菌评估的研究。我们没有发现 BV 相关细菌会增加子宫肌瘤发生率或数量的证据。
