Abdelkader Omar Khalid Samir, Hassan Noheir Ashraf Ibrahem Fathy, Radi Amro Mahmoud, Kamal Mennatallah, Al-Qizwini Karrar Hazim Abdul-Karim, Ezzat Abdelrahman, Popoola-Samuel Helen A O, Aiash Karim, Arora Ayaan, Elissawy Amir, Toraih Eman A, Hazimeh Yusef, Aiash Hani
Port Said University Faculty of Medicine, Port Said, Egypt.
Faculty of Medicine, Aswan University, Aswan, Egypt.
Ann Med Surg (Lond). 2025 Jul 25;87(9):5999-6007. doi: 10.1097/MS9.0000000000003655. eCollection 2025 Sep.
Bacterial vaginosis, resulting from vaginal microbiota imbalance and lactobacilli depletion, is the leading cause of abnormally appearing discharge in reproductive-aged women. Bacterial vaginosis is also associated with risk for sexually transmitted infections, preterm birth, and pelvic inflammatory disease. This meta-analysis assessed the association between the risk of bacterial vaginosis (BV) and body mass index (BMI).
We systematically searched electronic databases using terms for weight, vaginosis, obesity, and BMI. We also reviewed gray literature, reference lists, and trials registries and sought the advice of experts. We calculated the overall odds ratios (OR) and the 95% confidence intervals (CI) using fixed-effect model for homogenous data and random-effects models for heterogenous data.
Eight observational studies ( = 22 190) were included, with quality assessment scores ranging from 7 to 9. Compared with normal-weight women (BMI 18.5-24.9), underweight women (BMI <18.5) had significantly higher prevalence of bacterial vaginosis (OR: 1.23; 95% CI: 1.12-1.36; < 0.001). No significant associations were found for overweight (OR: 1.19; 95% CI: 0.95-1.48; = 0.13) or obesity (OR: 1.29; 95% CI: 0.91-1.82; = 0.15).
Our findings suggest a significant association between underweight status and an increased likelihood of being diagnosed with bacterial vaginosis. However, causality cannot be established due to the observational nature of the included studies. Further prospective research is needed to confirm this relationship.
细菌性阴道病是育龄期女性白带异常的主要原因，由阴道微生物群失衡和乳酸杆菌减少引起。细菌性阴道病还与性传播感染、早产和盆腔炎的风险相关。本荟萃分析评估了细菌性阴道病（BV）风险与体重指数（BMI）之间的关联。
我们使用与体重、阴道病、肥胖和BMI相关的术语系统检索了电子数据库。我们还查阅了灰色文献、参考文献列表和试验注册库，并征求了专家意见。对于同质数据，我们使用固定效应模型计算总体比值比（OR）和95%置信区间（CI）；对于异质数据，我们使用随机效应模型。
纳入了8项观察性研究（n = 22190），质量评估分数在7至9之间。与体重正常的女性（BMI 18.5 - 24.9）相比，体重过轻的女性（BMI < 18.5）患细菌性阴道病的患病率显著更高（OR：1.23；95% CI：1.12 - 1.36；P < 0.001）。超重（OR：1.19；95% CI：0.95 - 1.48；P = 0.13）或肥胖（OR：1.29；95% CI：0.91 - 1.82；P = 0.15）者未发现显著关联。
我们的研究结果表明体重过轻状态与被诊断为细菌性阴道病的可能性增加之间存在显著关联。然而，由于纳入研究的观察性性质，无法确定因果关系。需要进一步的前瞻性研究来证实这种关系。
