Evaluation of Specific Symptoms of Bacterial Vaginosis Among Pregnant Women

OBJECTIVE Identification of the symptoms of bacterial vaginosis (BV) in pregnancy might be rational in order to identify a possible BV-associated group at risk of preterm delivery. METHODS Three hundred and five women early in the third trimester of pregnancy were interviewed about lifestyle factors and specific symptoms of BV and given a vaginal examination. A longitudinal three-week follow-up was conducted for 127 women. RESULTS The prevalence of BV was 16%. Women with BV were significantly more often smokers than women without BV (52% vs. 34%). No difference in sexual activity or other behavioral characteristics between the two groups were seen. No differences were noted among women with and without BV according to specific symptoms: malodorous discharge (26% vs. 23%), increased discharge (76% vs. 68%), or itching or troublesome discharge. More than one third of women with BV at the first examination did not fulfill the criteria for BV at the three week follow-up exam. None of the women without BV had developed BV by the follow-up exam. The incidence of preterm delivery among women with BV was 4%, women without BV had an incidence of 2.4%. This difference was not statistically significant. CONCLUSION Asymptomatic BV in pregnancy is common. Specific questions about the character of the discharge do not identify women with BV during pregnancy. To identify a potential BV-associated group at risk for preterm delivery, screening for BV must be conducted not only among symptomatic women but among all women. Women with BV are more often smokers than women without BV.