Department of Obstetrics & Gynecology, Peking University First Hospital, Beijing, China.
Department of Obstetrics & Gynecology, Beijing Obstetrics and Gynecology Hospital, Beijing, China.
Postgrad Med. 2022 Sep;134(7):659-667. doi: 10.1080/00325481.2022.2113286. Epub 2022 Aug 19.
Asymptomatic bacterial vaginosis (aBV) is prevalent in the general population, while a previous study only investigated the natural history of aBV in women at high-risk. This stage study was to investigate the natural history of aBV in Chinese Han women at general risk and examine risk factors associated with different outcomes.
Women of reproductive age with aBV were enrolled and prospectively followed up with for four months. Participants were classified into one of three outcomes: progress, self-cure or no-change. Univariate and multivariate analyses were used to determine the association between potential risk factors and outcomes.
A total of 3420 subjects were screened and 1014 women with aBV were enrolled. Eventually, 984 participants completed the study, with 30 patients dropped out. Among the 984 cases, 42 cases self-cured spontaneously, while 433 cases progressed and 509 cases did not change significantly. Of the 433 cases that progressed, several types of mixed infections were observed in addition to 196 symptomatic bacterial vaginosis. According to univariate analysis, frequent travel (OR, 95% CI, 2.73 [2.09 ~ 3.55]) and history of bacterial vaginosis (BV) (5.47, [4.15 ~ 7.21]) exhibited significant associations with aBV progression, while condom contraception (0.46 [0.36 ~ 0.61]) and lower Nugent score (0.49, [0.37 ~ 0.64]) demonstrated protective effects for self-cure. According to multivariate regression analysis, the risk factors for aBV progression were history of BV (6.67, [4.86 ~ 9.15]) and frequent travel (3.57, 2.59 ~ 4.92). Condom contraception (0.36, 0.26 ~ 0.49) exhibited a protective effect against aBV progression.
Without intervention, a large proportion of aBV would progress, compared to the very few patients whose aBV self-cured spontaneously. It is necessary to clinically intervene aBV patients. Condom utilization can be used as an effective method to improve the outcome of aBV.
无症状细菌性阴道病（aBV）在普通人群中较为常见，而之前的研究仅调查了高危人群中 aBV 的自然史。本阶段研究旨在调查普通风险的中国汉族女性中 aBV 的自然史，并研究与不同结局相关的危险因素。
纳入育龄期患有 aBV 的女性，并对其进行为期四个月的前瞻性随访。参与者被分为以下三种结局之一：进展、自行治愈或无变化。采用单因素和多因素分析来确定潜在危险因素与结局之间的关系。
共筛选了 3420 名受试者，纳入了 1014 名患有 aBV 的女性。最终，984 名参与者完成了研究，有 30 名患者脱落。在 984 例中，有 42 例自发自行治愈，433 例进展，509 例无明显变化。在 433 例进展的病例中，除了 196 例有症状的细菌性阴道病外，还观察到了几种混合感染类型。单因素分析显示，频繁旅行（比值比，95%置信区间，2.73[2.093.55]）和细菌性阴道病（BV）史（5.47[4.157.21]）与 aBV 进展显著相关，而避孕套避孕（0.46[0.360.61]）和较低的 Nugent 评分（0.49[0.370.64]）对自行治愈具有保护作用。多因素回归分析显示，aBV 进展的危险因素为 BV 史（6.67[4.869.15]）和频繁旅行（3.57[2.594.92]）。避孕套避孕（0.36[0.26~0.49]）对 aBV 进展具有保护作用。
未经干预，aBV 会有很大一部分进展，而仅有极少数患者会自发自行治愈。有必要对 aBV 患者进行临床干预。避孕套的使用可以作为改善 aBV 结局的有效方法。
