title: The association of psychosocial stress and bacterial vaginosis in a longitudinal cohort.
abstract: OBJECTIVE
  The purpose of this study was to assess the association of psychosocial stress with bacterial vaginosis in a longitudinal sample of nonpregnant women.
  
  
  METHODS
  A 1-year prospective longitudinal design was used. Nonpregnant women (n = 3614) aged 15 to 44 years were recruited at routine health care visits. Assessments were conducted quarterly for 1 year and included a standardized pelvic examination, an assessment of clinical symptoms, and an extensive self-report interview.
  
  
  RESULTS
  Psychosocial stress was associated with overall prevalence of (adjusted odds ratio, 1.10; 95% CI, 1.01-1.20) and an increased incidence of (adjusted odds ratio, 1.29; 95% CI, 1.12-1.48) bacterial vaginosis. The association between stress and bacterial vaginosis incidence was not changed appreciably by the control for behavioral and demographic characteristics and was magnified (odds ratio, 2.05; 95% CI, 1.15-3.66) in a case-crossover analysis.
  
  
  CONCLUSIONS
  Increased psychosocial stress is associated with greater bacterial vaginosis prevalence and incidence independent of other risk factors.
authors.affiliation: Division of Epidemiology, Statistics and Prevention Research, Department of Health and Human Services, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892-7510, USA. nanselt@mail.nih.gov
authors.forename: Tonja R
authors.initials: TR
authors.lastname: Nansel
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Riggs
authors.forename: Kai-Fun
authors.initials: KF
authors.lastname: Yu
authors.forename: William W
authors.initials: WW
authors.lastname: Andrews
authors.forename: Jane R
authors.initials: JR
authors.lastname: Schwebke
authors.forename: Mark A
authors.initials: MA
authors.lastname: Klebanoff
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D011446:Prospective Studies; D013315:Stress, Psychological / Q000453:epidemiology*; D016585:Vaginosis, Bacterial / Q000453:epidemiology* / Q000523:psychology*