Systematic review and meta-analysis of maternal and fetal outcomes among pregnant women with bacterial vaginosis

Kenfack-Zanguim, Josiane; Kenmoe, Sebastien; Bowo-Ngandji, Arnol; Kenfack-Momo, Raoul; Thierry Ebogo-Belobo, Jean; Kengne-Ndé, Cyprien; Serge Mbaga, Donatien; Zeuko'o Menkem, Elisabeth; Lontuo Fogang, Robertine; Tchatchouang, Serges; Laure Ndzie Ondigui, Juliette; Irma Kame-Ngasse, Ginette; Nina Magoudjou-Pekam, Jeannette; Roussel Takuissu, Guy; Nkie Esemu, Seraphine; Nantcho Clavela, Nguepgjio; Barriere Fodjo, Airy; Ndip, Lucy; Bigoga, Jude; Megnekou, Rosette; Esemu, Livo F.

doi:10.1016/j.ejogrb.2023.08.013

Cited by 10 publications

(4 citation statements)

References 42 publications

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“…Moreover, the study unveiled a significant association between BV and PTB, with an odds ratio (OR) of 1.76 and a 95% confidence interval from 1.32 to 2.35. Additionally, BV was also linked to the premature rupture of membranes (PROMs) with an OR of 2.59 and a 95% confidence interval from 1.39 to 4.82 [33].…”

Section: Discussionmentioning

confidence: 99%

Cracking the Code: Investigating the Correlation between Aerobic Vaginitis and Preterm Labor

Zarmakoupi,

Psarris,

Karasmani

et al. 2024

Medicina

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Aerobic vaginitis (AV) is a distinct clinical entity characterized by inflammation and abnormal vaginal microflora. Often mistaken for bacterial vaginosis, AV remains relatively unknown and underdiagnosed. AV’s understanding is evolving, with some experts suggesting it may primarily be an immunological disorder, the prevalence of which has a range of 7–13% in non-pregnant women and 4.1–8.3% during pregnancy. Pregnancy can affect susceptibility to vaginal infections, leading to adverse outcomes for the woman and the newborn. This review summarizes the correlation between AV and adverse pregnancy outcomes, particularly preterm birth, the leading cause of morbidity and mortality among neonates. An improved understanding of AV’s impact on pregnancy outcomes can lead to early recognition, proper management, and effective interventions. While some studies support an association between AV and preterm labor, the existing knowledge of this relationship remains limited. The evidence suggests that AV may contribute to adverse pregnancy outcomes, mainly preterm birth, but further research is needed to establish a definitive link. Further studies are needed to investigate the underlying mechanisms and clarify AV’s role in premature labor. A comprehensive understanding of AV’s impact on pregnancy outcomes is crucial for early recognition, appropriate management, and effective interventions.

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Section: Discussionmentioning

confidence: 99%

Cracking the Code: Investigating the Correlation between Aerobic Vaginitis and Preterm Labor

Zarmakoupi,

Psarris,

Karasmani

et al. 2024

Medicina

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“…(29) When present, particularly in early pregnancy, BV has been associated with an increased risk of miscarriage, preterm birth, low birth weight, need for advanced life support (neonatal), premature rupture of membranes and intrauterine infection. (8,30) However, the results related to the poor gestational prognosis are contradictory and not confirmed in important publications. (31) Certainly the host's immune factors with the individual variations and the specific virulence of each microbial strain involved in the par-ticular genesis of that case of BV in pregnant women appear to influence the occurrence of adverse events and complications.…”

Section: Does the Vaginal Microbiome Undergo Any Adaptation During Pr...mentioning

confidence: 99%

“…(7) During pregnancy, in addition to maternal repercussions, vulvovaginitis is associated with unfavorable obstetric outcomes such as preterm labor, premature rupture of membranes, low birth weight and puerperal infection. (8) Note that preterm birth complications represent the first cause of neonatal mortality, corresponding to approximately 35% of the 3.1 million neonatal deaths occurring annually in the world, and genital tract infections have a protagonist role in this situation. (9) Although some studies in the literature present controversial results regarding changes in the genital microbiome and unfavorable gestational outcomes, such studies were developed using simple methods of identifying microorganisms, such as bacterioscopy and/or culture, which have limitations in their results.…”

Section: Introductionmentioning

confidence: 99%

Vulvovaginitis in pregnant women

Duarte,

Linhares,

Kreitchmann

et al. 2024

Revista Brasileira De Ginecologia E Obstetrícia / RBGO Gynecology and Obstetrics

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Keypoints• The balanced vaginal microbiome is the main factor defending the vaginal environment against infections. Lactobacilli play a key role in this regard, maintaining the vaginal pH within the normal range (3.8 to 4.5).• Hormonal and immune adaptations resulting from pregnancy influence changes in the vaginal microbiome during pregnancy. • An altered vaginal microbiome predisposes to human immunodeficiency virus (HIV) infection.• Bacterial vaginosis is the main clinical expression of an imbalanced vaginal microbiome.• Vulvovaginal candidiasis depends more on the host's conditions than on the etiological agent.• Trichomonas vaginalis is a protozoan transmitted during sexual intercourse.• The use of probiotics is not approved for use in pregnant women. Recommendations• All complaints of changes in the vaginal contents reported by the pregnant woman must be evaluated to rule out both the changes in the vaginal microbiome and other genital infections. • Microscopic examination for direct or Gram-stained examination should always be carried out when suspicious changes of infections are detected in the vaginal contents. • The Amsel's criteria and staining of the vaginal content smear according to Nugent criteria are used in the diagnosis of bacterial vaginosis in our country. • The use of metronidazole for seven days is the preferred treatment of bacterial vaginosis in pregnant women. Although oral and vaginal treatments are efficient, oral treatment for seven days is preferred. If there is any impediment to the use of metronidazole, oral clindamycin is also a more commonly used option. • The wet mount vaginal swab of the vaginal contents is indicated to complement the clinical examination in the diagnosis of vulvovaginal candidiasis. Culture and antifungigrams are only indicated in relapses. • Vulvovaginal candidiasis in pregnant women must be treated with imidazole derivatives vaginally for seven days, as oral antifungal medications are not approved for use in pregnant women. • The wet mount vaginal swab of the vaginal contents is the main test to confirm the diagnosis of trichomoniasis. • The choice for the treatment of vaginal trichomoniasis is oral metronidazole for seven days. Single-dose oral treatment or vaginal treatment produce results with higher failure rates. • The best strategy must be established in each service, aiming to include the partner in antenatal care.

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“…In addition to the common symptoms of vaginitis, they can also lead to a higher likelihood of pelvic inflammatory disease and HPV infection. When present during pregnancy, the risks of miscarriage, preterm labor, chorioamnionitis, neonatal infections, and other adverse outcomes increase significantly ( Feng et al., 2023 ; Kenfack-Zanguim et al., 2023 ; Qulu et al., 2023 ).…”

Section: Introductionmentioning

confidence: 99%

In vitro biofilm formation of Gardnerella vaginalis and Escherichia coli associated with bacterial vaginosis and aerobic vaginitis

Shang,

Bai,

Fan

et al. 2024

Front. Cell. Infect. Microbiol.

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ObjectiveTo determine the optimum biofilm formation ratio of Gardnerella vaginalis (G. vaginalis) in a mixed culture with Escherichia coli (E. coli).MethodsG. vaginalis ATCC14018, E. coli ATCC25922, as well as five strains of G. vaginalis were selected from the vaginal sources of patients whose biofilm forming capacity was determined by the Crystal Violet method. The biofilm forming capacity of E. coli in anaerobic and non-anaerobic environments were compared using the identical assay. The Crystal Violet method was also used to determine the biofilm forming capacity of a co-culture of G. vaginalis and E. coli in different ratios. After Live/Dead staining, biofilm thickness was measured using confocal laser scanning microscopy, and biofilm morphology was observed by scanning electron microscopy.ResultsThe biofilm forming capacity of E. coli under anaerobic environment was similar to that in a 5% CO2 environment. The biofilm forming capacity of G. vaginalis and E. coli was stronger at 106:105 CFU/mL than at other ratios (P<0.05). Their thicknesses were greater at 106:105 CFU/mL than at the other ratios, with the exception of 106:102 CFU/mL (P<0.05), under laser scanning microscopy. Scanning electron microscopy revealed increased biofilm formation at 106:105 CFU/mL and 106:102 CFU/mL, but no discernible E. coli was observed at 106:102 CFU/mL.ConclusionG. vaginalis and E. coli showed the greatest biofilm forming capacity at a concentration of 106:105 CFU/mL at 48 hours and could be used to simulate a mixed infection of bacterial vaginosis and aerobic vaginitis in vitro.

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Systematic review and meta-analysis of maternal and fetal outcomes among pregnant women with bacterial vaginosis

Cited by 10 publications

References 42 publications

Cracking the Code: Investigating the Correlation between Aerobic Vaginitis and Preterm Labor

Cracking the Code: Investigating the Correlation between Aerobic Vaginitis and Preterm Labor

Vulvovaginitis in pregnant women

In vitro biofilm formation of Gardnerella vaginalis and Escherichia coli associated with bacterial vaginosis and aerobic vaginitis

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