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Infectious Diseases in Obstetrics and Gynecology
Volume 2006, Article ID 94646, 6 pages
Clinical Study

Acquisition and Elimination of Bacterial Vaginosis During Pregnancy: A Danish Population-Based Study

1NANEA, Department of Epidemiology, Institute for Public Health, University of Aarhus, Aarhus C 8000, Denmark
2Department of Clinical Genetics, Aarhus University hospital, Aarhus C 8000, Denmark
3Institute of Public Health, University of Southern Denmark, Odense C 5000, Denmark
4Perinatal Center, Department of Obstetrics and Gynecology, Sahlgrenska Academy, Göteborg University, Göteborg 405 30, Sweden
5Department of Obstetrics and Gynecology, Odense University Hospital, Odense C 5000, Denmark
6Department of Clinical Microbiology, Frederiksberg Hospital, Frederiksberg, Copenhagen 2000, Denmark

Received 1 January 2006; Accepted 28 March 2006

Copyright © 2006 Ida Vogel et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objectives: the aim was to examine factors associated with acquisition and elimination of bacterial vaginosis in pregnancy. Methods: a group of 229 pregnant women were randomly selected from a population-based prospective cohort study of 2927. They were examined at enrollment (mean gestational weeks 16w+0d) and again in mid-third trimester (mean gestational age 32w+3d). Measures: BV (Amsel's clinical criteria), microbiological cultures of the genital tract and questionnaire data. Results: BV prevalence decreased from 17% in early second trimester to 14% in mid-third trimester due to a tenfold higher elimination rate (39%) than incidence rate (4%). Heavy smokers (>10/d) in early pregnancy were at increased risk (5.3 [1.125]) for the acquisition of BV during pregnancy, as were women receiving public benefits (4.8 [1.022]), having a vaginal pH above 4.5 (6.3 [1.429]) or vaginal anaerobe bacteria (18 [2.7122]) at enrollment. A previous use of combined oral contraceptives was preventive for the acquisition of BV (0.2 [0.030.96]). Elimination of BV in pregnancy tended to be associated with a heavy growth of Lactobacillus(3.2 [0.813]) at enrollment. Conclusions: acquisition of BV during pregnancy is rare and is associated with smoking, while the presence of anaerobe bacteria and a vaginal pH > 4.5 are interpreted as steps on a gradual change towards BV. In the same way heavy growth of Lactobacillus spp in early pregnancy may be an indicator of women on the way to eliminate BV.