Prospective validation of a perinatal bacterial vaginosis screening risk score.
OBJECTIVE
Prospectively validate an antenatal bacterial vaginosis (BV) risk score at two public health department obstetrics clinics.


METHODS
Women (n=409) entering prenatal care received a BV risk score (range 0 to 16) at their first visit and at 24 to 28 weeks' gestation. BV was measured with Gram-stained vaginal smears. Normal discharge was used as a surrogate for being asymptomatic.


RESULTS
Approximately half of the women scored > or =3 at each assessment. In total 29% had true BV at the first assessment (13% at the second assessment). The BV risk score (> or =3) had 91% sensitivity and 63% specificity, and the BV risk score (> or =5) had 88% sensitivity and 76% specificity. Among true cases, 42% were asymptomatic, of which 77% had risk scores > or =3. All symptomatic BV cases had risk scores > or =3.


CONCLUSIONS
In practice, the risk score identified both asymptomatic and symptomatic cases. Asymptomatic women are of particular interest because they are not screened for BV under current practice guidelines.
Department of Obstetrics and Gynecology, School of Medicine, University of Virginia, Charlottesville, VA 22908-0712, USA.
Lisa M
LM
Pastore
Tonya S
TS
King
Ida J
IJ
Dawson
Alisa
A
Hollifield
John M
JM
Thorp
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D018743:Perinatal Care; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis*; D011296:Prenatal Diagnosis; D011446:Prospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D014626:Vaginal Smears; D016585:Vaginosis, Bacterial / Q000175:diagnosis*