Ng Beng Kwang, Chuah Joo Ngor, Cheah Fook Choe, Mohamed Ismail Nor Azlin, Tan Geok Chin, Wong Kon Ken, Lim Pei Shan
Department of Obstetrics and Gynaecology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
Department of Paediatrics, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
Front Surg. 2023 Feb 13;10:1084867. doi: 10.3389/fsurg.2023.1084867. eCollection 2023.
Bacterial vaginosis (BV) is a common infection in women of reproductive age group because of vaginal dysbiosis. The impact of BV during pregnancy is still not well defined. The objective of this study is to assess the maternal-fetal outcome in women with BV.
A prospective cohort study over one-year duration was conducted from December, 2014 until December, 2015, involving 237 women who presented with abnormal vaginal discharge, preterm labour or preterm prelabour rupture of membrane between 22- and 34-weeks period of gestation. Vaginal swabs were sent for culture and sensitivity, BV® Blue testing and PCR for Gardnerella vaginalis (GV).
BV was diagnosed in 24/237 (10.1%) cases. The median gestational age was 31.6 weeks. GV was isolated from 16 out of 24 (66.7%) in the BV positive group. There was a significantly higher preterm birth rate, below 34 weeks (22.7% vs. 6.2%, = 0.019) in women with BV. There was no statistically significant difference in maternal outcome such as clinical chorioamnionitis or endometritis. However, placental pathology revealed more than half (55.6%) of women with BV had histologic chorioamnionitis. Neonatal morbidity was significantly higher with exposure to BV, with a lower median birth weight, higher rate of neonatal intensive care unit admission (41.7% vs. 19.0%, = 0.010), increased intubation for respiratory support (29.2% vs. 7.6%, = 0.004) and respiratory distress syndrome (33.3% vs. 9.0%, = 0.002).
More research is needed to formulate guidelines for prevention, early detection and treatment of BV during pregnancy to reduce intrauterine inflammation and the associated adverse fetal outcomes.
细菌性阴道病（BV）是育龄期女性因阴道生态失调而常见的一种感染。BV在孕期的影响仍未明确界定。本研究的目的是评估患有BV的女性的母婴结局。
2014年12月至2015年12月进行了一项为期一年的前瞻性队列研究，纳入了237名在妊娠22至34周期间出现阴道分泌物异常、早产或胎膜早破的女性。阴道拭子送去进行培养及药敏试验、BV蓝检测和阴道加德纳菌（GV）的聚合酶链反应检测。
237例病例中有24例（10.1%）诊断为BV。中位孕周为31.6周。BV阳性组24例中有16例（66.7%）分离出GV。患有BV的女性早产率显著更高，低于34周的早产率（22.7%对6.2%，P = 0.019）。在母体结局方面，如临床绒毛膜羊膜炎或子宫内膜炎，无统计学显著差异。然而，胎盘病理学显示超过一半（55.6%）患有BV的女性有组织学绒毛膜羊膜炎。暴露于BV的新生儿发病率显著更高，出生体重中位数更低，新生儿重症监护病房入住率更高（41.7%对19.0%，P = 0.010），呼吸支持插管增加（29.2%对7.6%，P = 0.004）以及呼吸窘迫综合征（33.3%对9.0%，P = 0.002）。
需要更多研究来制定孕期BV的预防、早期检测和治疗指南，以减少宫内炎症及相关不良胎儿结局。
