Race/ethnicity, vaginal flora patterns, and pH during pregnancy.
OBJECTIVE
To investigate the relationship between bacterial vaginosis during pregnancy and black race/ethnicity.


METHODS
Gram staining was used to evaluate vaginal flora in 842 women at 24 to 29 weeks' gestation.


RESULTS
Overall, 22.3% of blacks and 8.5% of whites had bacterial vaginosis. Vaginal pH and flora differed significantly by race/ethnicity; blacks were more likely to have pH > or = 4.5, no lactobacilli, small gram-variable and -negative rods, and Mobiluncus compared with whites (odds ratios 1.6, 1.5, 1.4, and 10.6, respectively). Quantity of morphotypes also differed, especially for Mobiluncus. Among women with Mobiluncus present (12.0% of blacks and 1.3% of whites), 73.3% of blacks compared with 40.0% of whites had the highest level. Adjustment for sociodemographics, sexual activity, sexually transmitted diseases, health behavior, and sexual hygiene did not explain these differences.


CONCLUSIONS
We observed race/ethnicity differences in vaginal flora ecology. These differences may ultimately play a role in the larger proportion of preterm deliveries among black women compared with white women.
Royce
R A
RA
Department of Epidemiology, School of Public Health, University of North Carolina at Chapel Hill 27599, USA. Rachel_Royce@unc.edu
Jackson
T P
TP
Thorp
J M
JM
Hillier
S L
SL
Rabe
L K
LK
Pastore
L M
LM
Savitz
D A
DA
D000293:Adolescent; D000328:Adult; D001419:Bacteria / Q000302:isolation & purification; D044383:Black People; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007752:Obstetric Labor, Premature / Q000208:ethnology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis / Q000208:ethnology* / Q000382:microbiology; D014621:Vagina / Q000382:microbiology*; D016585:Vaginosis, Bacterial / Q000175:diagnosis / Q000208:ethnology* / Q000382:microbiology; D044465:White People