title: Elevated vaginal pH in the absence of current vaginal infection, still a challenging obstetrical problem.
abstract: OBJECTIVE
  To assess the association of vaginal pH ≥ 5 in the absence of vaginal infection with systemic inflammation and adverse pregnancy outcome.
  
  
  METHODS
  Four-hundred sixty pregnant women completed the study, upon enrollment Vaginal pH was measured for all women, maternal and umbilical sera were obtained for determining C-reactive protein (CRP) and uric acid levels. Umbilical blood was tested for gas parameters, 1 and 5 min Apgar scores, the need for neonatal resuscitation and neonatal intensive care unit (NICU) admission were recorded.
  
  
  RESULTS
  Elevated vaginal pH was significantly associated with preterm birth (odds ratio (OR), 2.23; 95% confidence interval (CI), 1.04-4.76), emergency cesarean section (OR 2.57; 95% CI 1.32-5), neonatal resuscitation in the delivery room (OR 2.85; 95% CI 1.1-7.38), elevated cord base deficit (OR 8.01; 95% CI 1.61-39.81), low cord bicarbonate (OR 4.16, 95% CI 1.33-12.92) and NICU admission (OR 2.02; 95% CI 1.12-3.66). Increased vaginal pH was also significantly associated with maternal leukocytosis, hyperuricemia and elevated CRP levels in maternal and umbilical sera.
  
  
  CONCLUSIONS
  Elevated vaginal pH in the absence of current vaginal infection still constitutes a risk for adverse pregnancy outcome which is mediated by systemic inflammatory response.
authors.affiliation: Maternal, Fetal and Neonatal Research Center .
authors.forename: Sedigheh
authors.initials: S
authors.lastname: Hantoushzadeh
authors.forename: Mahdi
authors.initials: M
authors.lastname: Sheikh
authors.forename: Pouya
authors.initials: P
authors.lastname: Javadian
authors.forename: Mamak
authors.initials: M
authors.lastname: Shariat
authors.forename: Elaheh
authors.initials: E
authors.lastname: Amini
authors.forename: Alireza
authors.initials: A
authors.lastname: Abdollahi
authors.forename: Maryam
authors.initials: M
authors.lastname: Kashanian
mesh_terms: D000137:Acid-Base Imbalance / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D000328:Adult; D002097:C-Reactive Protein / Q000032:analysis; D015331:Cohort Studies; D005260:Female; D005312:Fetal Blood / Q000737:chemistry; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007231:Infant, Newborn; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology*; D011256:Pregnancy Outcome / Q000453:epidemiology*; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood / Q000150:complications / Q000453:epidemiology*; D014527:Uric Acid / Q000097:blood; D014621:Vagina / Q000737:chemistry*; D055815:Young Adult
chemical_list: D014527:Uric Acid; D002097:C-Reactive Protein