title: Association of pregnancy and Candida vaginal colonization in women with or without symptoms of vulvovaginitis.
abstract: OBJECTIVE
  Candida infection is one of the main causes of vulvovaginitis. The experience of symptoms of vulvovaginitis during pregnancy changes in relation to clinical, behavioral, and demographic factors. Candidiasis is associated with an increased risk of delivery complications. In some studies pregnant women are found more symptomatic than non-pregnant women, but in others a higher prevalence of asymptomatic infections is described during pregnancy. The aims of this study were to evaluate the prevalence of Candida vaginal colonization in pregnant women, and investigate if the occurrence of symptoms is influenced by pregnancy, in a population of Italian native and immigrant women.
  
  
  METHODS
  A total of 344 outpatients, who visited the laboratory for routine genital examination, independently of pregnancy or presence or absence of symptoms of vulvovaginitis, were evaluated.
  
  
  RESULTS
  Colonization by Candida spp. was significantly higher in pregnant than non-pregnant patients (31.4% vs. 19.9%; χ2=5.59; P=0.018), nevertheless pregnant women were significantly more often asymptomatic compared to non-pregnant (46.5% vs. 16%; χ2=42.31; P<0.0001). In the sub-group of women colonized by Candida spp., pregnancy resulted significantly associated to asymptomatic infection (58.1% vs. 30.8%; χ2 =6.18; P=0.013). A binary logistic regression analysis showed pregnancy or lactobacilli colonization independently associated to a lower probability of experiencing symptoms of vulvovaginitis (respectively: P<0.0001 and P=0.008).
  
  
  CONCLUSIONS
  Pregnancy seems to be independently associated to Candida spp. asymptomatic vaginal infection. Given that candidiasis has been associated with possible delivery complications, these results suggest to screen for Candida spp. vaginal colonization asymptomatic women during pregnancy.
authors.affiliation: Microbiology Section, Department of Experimental, Medicine and Biochemical Sciences, University of Perugia, Perugia, Italy. christian.leli@libero.it
authors.forename: C
authors.initials: C
authors.lastname: Leli
authors.forename: A
authors.initials: A
authors.lastname: Mencacci
authors.forename: M
authors.initials: M
authors.lastname: Meucci
authors.forename: C
authors.initials: C
authors.lastname: Bietolini
authors.forename: M
authors.initials: M
authors.lastname: Vitali
authors.forename: S
authors.initials: S
authors.lastname: Farinelli
authors.forename: F
authors.initials: F
authors.lastname: D' Alò
authors.forename: J C
authors.initials: JC
authors.lastname: Bombaci
authors.forename: S
authors.initials: S
authors.lastname: Perito
authors.forename: F
authors.initials: F
authors.lastname: Bistoni
mesh_terms: D000293:Adolescent; D000328:Adult; D002175:Candida / Q000302:isolation & purification*; D002181:Candidiasis, Vulvovaginal / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D006801:Humans; D007558:Italy; D016015:Logistic Models; D008875:Middle Aged; D010045:Outpatients; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology / Q000382:microbiology*; D015995:Prevalence; D055815:Young Adult