Abstract

BackgroundBacterial vaginosis (BV) is associated with a higher risk of preterm delivery and spontaneous abortion. Yet little data on BV prevalence exist for sub-Saharan countries. The aim of this study was to estimate the prevalence of bacterial vaginosis and associated risk factors among pregnant women in Senegal.MethodsFrom October 2013 to December 2018, pregnant women in their third trimester were recruited in two primary health centers (one suburban, one rural) in Senegal. Healthcare workers interviewed women and collected a lower vaginal swab and a blood sample. Vaginal flora were classified into four categories using vaginal smear microscopic examination and Gram’s coloration. In our study, BV was defined as vaginal flora with no Lactobacillus spp. Variables associated with BV were analyzed using STATA® through univariate and multivariate analysis.ResultsA total of 457 women provided a vaginal sample for analysis. Overall, BV prevalence was 18.6% (85/457) [95% CI 15.4–22.6]) and was similar in suburban and rural areas (18.9% versus 18.1%, p = 0.843). Multivariate analysis showed that primigravidity was the only factor independently associated with a lower risk of BV (aOR 0.35 [95% CI 0.17–0.72]).ConclusionsOur study showed significant BV prevalence among pregnant women in Senegal. Although the literature has underscored the potential consequences of BV for obstetric outcomes, data are scarce on BV prevalence in sub-Saharan African countries. Before authorities consider systematic BV screening for pregnant women, a larger study would be useful in documenting prevalence, risk factors and the impact of BV on pregnancy outcomes.

Highlights

  • Bacterial vaginosis (BV) is associated with a higher risk of preterm delivery and spontaneous abortion

  • Bacterial vaginosis (BV) is defined as an imbalance of normal vaginal flora; it is characterized by high species diversity, depleted Lactobacillus spp., and increased anaerobes, such as Gardnerella vaginalis, Atopobium vaginae and other fastidious BV-associated bacteria [2]

  • According to a meta-analysis conducted among 20,232 pregnant women [3], women with BV have two times the risk of preterm delivery, and nine time higher risk of spontaneous abortion

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Summary

Introduction

Bacterial vaginosis (BV) is associated with a higher risk of preterm delivery and spontaneous abortion. The aim of this study was to estimate the prevalence of bacterial vaginosis and associated risk factors among pregnant women in Senegal. In 2015, neonatal mortality in Senegal was 47.2 per 1000 live births. Bacterial vaginosis (BV) is defined as an imbalance of normal vaginal flora; it is characterized by high species diversity, depleted Lactobacillus spp., and increased anaerobes, such as Gardnerella vaginalis, Atopobium vaginae and other fastidious BV-associated bacteria [2]. BV is a risk factor of adverse obstetric outcomes [3, 4]. According to a meta-analysis conducted among 20,232 pregnant women [3], women with BV have two times the risk of preterm delivery, and nine time higher risk of spontaneous abortion. BV is associated with a higher risk of sexually

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