Brown Sarah E, He Xin, Magder Laurence, Johnston Elizabeth D, Morgan Daniel, Ravel Jacques, Mark Katrina, Ghanem Khalil G, Brotman Rebecca M
Department of Epidemiology and Biostatistics, University of Maryland, College Park, MD, USA.
Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA.
Sex Transm Dis. 2025 May 26. doi: 10.1097/OLQ.0000000000002184.
Hyperosmolal lubricants may negatively affect the vaginal microenvironment, increasing the risk for bacterial vaginosis (BV). We compared the incidence of Amsel-defined BV in reproductive-age women exposed to hyperosmolal lubricant during transvaginal ultrasound to those without recent lubricant exposure.
We analyzed two observational cohorts over 10 weeks: 58 lubricant-exposed women from the Gynecology and Lubricants Effects study and 59 lubricant-unexposed women from a University of Alabama Birmingham cohort linked to the University of Maryland Human Microbiome Project. BV was diagnosed using Amsel criteria at baseline, mid-study (lubricant-exposed: week 2, lubricant-unexposed: week 5), and final visit (week 10), and categorized by symptomatology. Risks for incident BV and Amsel criteria were assessed using modified Poisson regression with robust standard errors. An additional outcome of new-onset/newly-symptomatic BV included those with baseline asymptomatic BV. A secondary analysis focused on Black participants (N = 73) due to an observed higher BV incidence.
Baseline demographics and behaviors were similar between the cohorts. Among all participants, lubricant was not associated with new-onset BV (adjusted relative risk (aRR):1.32, 95% CI:0.58-3.01). 88% (23/26) of all new-onset/newly-symptomatic BV cases occurred in Black participants. Among Black participants, exposure to lubricant doubled the risk of developing new-onset BV (aRR:2.18, 95% CI:1.16-4.11) and new-onset/newly-symptomatic BV (aRR:1.91, 95% CI: 1.04-3.51), and increased the risk for new-onset clue cells (aRR:2.18, 95% CI:1.17 - 4.06) versus no lubricant exposure.
Hyperosmolal lubricants was associated with BV incidence in Black women. Factors contributing to this elevated risk require further research.
高渗润滑剂可能会对阴道微环境产生负面影响，增加细菌性阴道病（BV）的风险。我们比较了在经阴道超声检查期间接触高渗润滑剂的育龄妇女与近期未接触润滑剂的妇女中，根据阿姆塞尔标准定义的BV发病率。
我们在10周内分析了两个观察性队列：来自妇科与润滑剂效应研究的58名接触润滑剂的妇女，以及来自阿拉巴马大学伯明翰分校队列（与马里兰大学人类微生物组计划相关）的59名未接触润滑剂的妇女。在基线、研究中期（接触润滑剂组：第2周，未接触润滑剂组：第5周）和末次访视（第10周）时，使用阿姆塞尔标准诊断BV，并根据症状进行分类。使用具有稳健标准误的修正泊松回归评估新发BV和阿姆塞尔标准的风险。新发/新出现症状的BV的另一个结果包括那些基线无症状性BV的患者。由于观察到黑人参与者的BV发病率较高，因此进行了一项针对黑人参与者（N = 73）的次要分析。
各队列之间的基线人口统计学和行为相似。在所有参与者中，润滑剂与新发BV无关（调整后相对风险（aRR）：1.32，95%置信区间：0.58 - 3.01）。所有新发/新出现症状的BV病例中有88%（23/26）发生在黑人参与者中。在黑人参与者中，接触润滑剂使新发BV（aRR：2.18，95%置信区间：1.16 - 4.11）和新发/新出现症状的BV（aRR：1.91，95%置信区间：1.04 - 3.51）的风险增加了一倍，并且与未接触润滑剂相比，新发线索细胞的风险增加（aRR：2.18，95%置信区间：1.17 - 4.06）。
高渗润滑剂与黑人女性的BV发病率相关。导致这种风险升高的因素需要进一步研究。
