Prevalence of fungi in the vagina, rectum and oral cavity in pregnant diabetic women: relation to gestational age and symptoms.
OBJECTIVE
To estimate the prevalence of fungi in the vagina, rectum and oral cavity in pregnant women with diabetes mellitus (DM) type I or gestational diabetes mellitus (GDM) and in healthy controls; to assess the influence of gestational age on the prevalence of fungi; to compare the vaginal symptoms within the groups; and to analyze the multifocality of fungal invasions.


METHODS
A total of 251 women were examined: 47 with DM, 72 with GDM and 132 controls. Samples were collected from the vagina, rectum and oral cavity of all women and cultured on Sabouraud media.


RESULTS
Fungi were found in 59.8% in at least one of the three locations in all women. Vaginal mycosis was diagnosed more often (p < 0.001) in pregnancies with DM [40.4%, odds ratio (OR) 4.3, confidence interval (CI) 2.41-4.85] than with GDM (22.2%, OR 1.84, CI 0.99-2.12) and nondiabetics (13.6%, OR 1.0). The risk of trifocal mycosis was higher in DM women (OR 2.7, CI 1.72-4.45), than in the controls. Only in 27.6% of symptomatic women were fungi detected in vagina. However, 60.4% of women with vaginal mycosis had symptoms. Among women without mycosis, 42.4% were symptomatic, and discharge was more common in the DM group (50%) than in the GDM group (21.4%) and the controls (28.1%; p < 0.002). The prevalence of fungi in the groups was not influenced by gestational age.


CONCLUSIONS
The risk of vaginal mycoses in DM women is more that four times higher and in pregnancies with GDM nearly two times higher than in controls. The risk of trifocal mycosis in DM women is nearly three times higher than in nondiabetics. There is a poor correlation between symptoms of vaginitis and fungal infection. We did not confirm the influence of the gestational age on the prevalence of fungi.
Department of Fetal-Maternal Medicine, Research Institute Polish Mother's Memorial Hospital, Lodz, Poland. dnowakowska@hotmail.com
Dorota
D
Nowakowska
Alicja
A
Kurnatowska
Babill
B
Stray-Pedersen
Jan
J
Wilczynski
D000328:Adult; D017677:Age Distribution; D016022:Case-Control Studies; D015897:Comorbidity; D016001:Confidence Intervals; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis / Q000453:epidemiology*; D016640:Diabetes, Gestational / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D016469:Fungemia / Q000175:diagnosis / Q000453:epidemiology; D005865:Gestational Age; D006801:Humans; D009055:Mouth / Q000382:microbiology; D009181:Mycoses / Q000175:diagnosis / Q000453:epidemiology*; D009664:Norway / Q000453:epidemiology; D016017:Odds Ratio; D011247:Pregnancy; D011256:Pregnancy Outcome; D015995:Prevalence; D011336:Probability; D012007:Rectum / Q000382:microbiology; D012016:Reference Values; D018570:Risk Assessment; D014621:Vagina / Q000382:microbiology