A cross-sectional study on the relationship of age, gestational age and HIV infection to bacterial vaginosis and genital mycoplasma infection.
OBJECTIVE
Pregnant women are especially at risk of developing complications when infected with reproductive tract infections (RTIs). The objective of this study was to determine the prevalence of bacterial vaginosis (BV) and genital mycoplasmas in pregnant women and investigate the associations between BV, genital mycoplasmas, HIV infection, age and gestational age.


METHODS
Cross-sectional study with descriptive and analytical components.


METHODS
Antenatal clinic of a tertiary academic hospital in South Africa.


METHODS
220 pregnant women older than 18 were included in the study and provided self-collected vaginal swabs.


METHODS
BV and genital mycoplasma colonisation and/or infection in women of differing age, gestational period and HIV status.


RESULTS
The prevalence of BV was 17.7% (39/220) (95% CI 12.9 to 23.4), intermediate vaginal flora (IVF) 15% (33/220) (95% CI 10.56 to 20.42), and the overall prevalence of genital mycoplasmas was 84% (185/220) (95% CI 78.47 to 88.58). BV was significantly associated with HIV infection with an OR of 2.84 (95% CI 1.08 to 7.46 and p value=0.034). However, BV was inversely associated with gestational age with an OR of 0.08 (95% CI 0.01 to 0.42 and p value=0.003) for second trimester pregnancies and an OR of 0.03 (95% CI 0.01 to 0.17 and p value<0.001) for third trimester pregnancies using the first trimester as reference. IVF was significantly associated with HIV infection with an OR of 2.7 (95% CI 1.07 to 6.79 and p value=0.035) but not with age or gestational age. Genital mycoplasmas were not significantly associated with age, gestational age, HIV status, BV flora or IVF.


CONCLUSIONS
The high infection rate of genital mycoplasmas and the association of BV with HIV found in this study reiterate the importance of screening for these RTIs in high-risk groups such as pregnant women.
Department of Medical Microbiology, University of Pretoria, Pretoria, South Africa.
Mathys J
MJ
Redelinghuys
Department of Medical Microbiology, University of Pretoria, Pretoria, South Africa Department of Medical Microbiology, Tshwane Academic Division, National Health Laboratory Service, Pretoria, South Africa.
Marthie M
MM
Ehlers
Centre for Tuberculosis, National Institute for Communicable Diseases, Johannesburg, South Africa.
Andries W
AW
Dreyer
Department of Obstetrics and Gynaecology, University of Pretoria, Pretoria, South Africa.
Hennie
H
Lombaard
Biostatistics Unit, South African Medical Research Council, Pretoria, South Africa.
Steve A S
SA
Olorunju
Department of Medical Microbiology, University of Pretoria, Pretoria, South Africa Department of Medical Microbiology, Tshwane Academic Division, National Health Laboratory Service, Pretoria, South Africa.
Marleen M
MM
Kock
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D003430:Cross-Sectional Studies; D005260:Female; D005865:Gestational Age; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D016015:Logistic Models; D015999:Multivariate Analysis; D009174:Mycoplasma / Q000235:genetics*; D009175:Mycoplasma Infections / Q000453:epidemiology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis*; D036301:Qualitative Research; D012307:Risk Factors; D013019:South Africa; D062606:Tertiary Care Centers; D014621:Vagina / Q000382:microbiology; D016585:Vaginosis, Bacterial / Q000453:epidemiology*; D055815:Young Adult
BACTERIOLOGY; QUALITATIVE RESEARCH