Abstract:
OBJECTIVES : Pregnant women are especially at risk of
developing complications when infected with
reproductive tract infections (RTIs). The objective of
this study was to determine the prevalence of bacterial
vaginosis (BV) and genital mycoplasmas in pregnant
women and investigate the associations between BV,
genital mycoplasmas, HIV infection, age and
gestational age.
DESIGN : Cross-sectional study with descriptive and
analytical components.
SETTING : Antenatal clinic of a tertiary academic hospital
in South Africa.
PARTICIPANTS : 220 pregnant women older than 18
were included in the study and provided self-collected
vaginal swabs.
PRIMARY AND SECONDARY OUTCOMES : BV and genital
mycoplasma colonisation and/or infection in women of
differing age, gestational period and HIV status.
RESULTS : The prevalence of BV was 17.7% (39/220)
(95% CI 12.9 to 23.4), intermediate vaginal flora (IVF)
15% (33/220) (95% CI 10.56 to 20.42), and the
overall prevalence of genital mycoplasmas was 84%
(185/220) (95% CI 78.47 to 88.58). BV was
significantly associated with HIV infection with an OR
of 2.84 (95% CI 1.08 to 7.46 and p value=0.034).
However, BV was inversely associated with gestational
age with an OR of 0.08 (95% CI 0.01 to 0.42 and p value=0.003) for second trimester pregnancies and an
OR of 0.03 (95% CI 0.01 to 0.17 and p value<0.001)
for third trimester pregnancies using the first trimester
as reference. IVF was significantly associated with HIV
infection with an OR of 2.7 (95% CI 1.07 to 6.79 and
p value=0.035) but not with age or gestational age.
Genital mycoplasmas were not significantly associated
with age, gestational age, HIV status, BV flora or IVF.
CONCLUSIONS : The high infection rate of genital
mycoplasmas and the association of BV with HIV
found in this study reiterate the importance of
screening for these RTIs in high-risk groups such as
pregnant women.
