title: Impact of Bacterial Vaginosis on Perineal Tears during Delivery: A Prospective Cohort Study.
abstract: OBJECTIVE
  Long term effects of perineal tears pose a major worldwide health issue for women during delivery. Since bacterial vaginosis is related to major obstacles in obstetrics the aim of this study was to determine the relationship between bacterial vaginosis and the occurrence of perineal tears during vaginal delivery.
  
  
  METHODS
  Between June 2013 and December 2013 pregnant women delivering after 37 weeks were recruited at one University hospital / tertiary care referral center in the course of this single-center, prospective cohort study. Bacterial vaginosis was assessed according to Nugent score method. Logistic-regression model was used to estimate odds ratios, adjusted for other risk factors to test the relationship between bacterial vaginosis and the occurrence of 1st to 4th degree perineal tears in women undergoing vaginal delivery.
  
  
  RESULTS
  A total of 728 woman were included, 662 analyzed with a complete Nugent Score of the vaginal swab. The prevalence of 1st to 4th degree perineal tears was 35.8% (95% Confidence Interval (95%CI) = [32.2; 39.6]). The presence of BV was not significantly associated to the incidence of perineal tears neither in the univariate analysis (crude Odds Ratio = 1.43; 95%CI = [0.79; 2.60]; p = 0.235) nor in the multivariate analysis (adjusted Odds Ratio = 1.65; 95%CI = [0.81; 3.36]; p = 0.167). Instrumental delivery was the most important risk factor for perineal lacerations.
  
  
  CONCLUSIONS
  There is no evidence that vaginosis is a risk factor for vaginal tears.
  
  
  BACKGROUND
  ClinicalTrials.gov N° NCT01822782.
authors.affiliation: Department of Obstetrics and Gynaecology, Nîmes University Hospital, Nîmes, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Letouzey
authors.affiliation: Department of Biostatistics, Epidemiology, Public Health and Bio-informatics, Nîmes University Hospital, Nîmes, France.|EA2415 University of Montpellier 1, Montpellier, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Bastide
authors.affiliation: Department of Obstetrics and Gynaecology, Nîmes University Hospital, Nîmes, France.
authors.forename: Daniela
authors.initials: D
authors.lastname: Ulrich
authors.affiliation: Department of Obstetrics and Gynaecology, Nîmes University Hospital, Nîmes, France.
authors.forename: Laurie
authors.initials: L
authors.lastname: Beccera
authors.affiliation: Department of Biostatistics, Epidemiology, Public Health and Bio-informatics, Nîmes University Hospital, Nîmes, France.
authors.forename: Mariella
authors.initials: M
authors.lastname: Lomma
authors.affiliation: Department of Obstetrics and Gynaecology, Nîmes University Hospital, Nîmes, France.
authors.forename: Renaud
authors.initials: R
authors.lastname: de Tayrac
authors.affiliation: Department of Microbiology, Nîmes University Hospital, Nîmes, France.|National Institute of Health and Medical Research, U1047, University of Montpellier, Nîmes, France.
authors.forename: Jean Philippe
authors.initials: JP
authors.lastname: Lavigne
mesh_terms: D000293:Adolescent; D000328:Adult; D036861:Delivery, Obstetric / Q000009:adverse effects*; D004841:Episiotomy / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D022125:Lacerations / Q000209:etiology*; D008875:Middle Aged; D007744:Obstetric Labor Complications / Q000453:epidemiology*; D010502:Perineum / Q000293:injuries*; D011247:Pregnancy; D011379:Prognosis; D011446:Prospective Studies; D014621:Vagina / Q000601:surgery*; D016585:Vaginosis, Bacterial / Q000382:microbiology*; D055815:Young Adult