Impact of treatment and the contribution of persistent posttreatment bacterial vaginosis infection on pregnancy outcome among asymptomatic women: A cohort study

Objective: The objective of this study was to evaluate the effect of antibiotic treatment and posttreatment persistent bacterial vaginosis (BV) infection on pregnancy outcome among asymptomatic women. Materials and Methods: A prospective cohort study was conducted among consenting, asymptomatic pregnant women without background medical disorders. All participants were recruited in the second trimester and had BV testing using Nugent score. BV-positive women were treated with a 7-day course of metronidazole with a repeat posttreatment laboratory testing after 4 weeks. The primary outcome was pregnancy outcome of BV-positive versus negative women; the secondary outcomes were posttreatment laboratory BV test result and pregnancy outcome among women with resolution versus persistent infection. Data analysis was performed using SPSS version 21.0 and P < 0.05 was significant. Results: The prevalence of BV in pregnancy was 24.1%; vulva itching and vaginal douching were more common among BV-positive women (P = 0.011 and P = 0.001), respectively. Adverse pregnancy outcomes such as premature rupture of membranes (PROM) (odds ratio [OR]: 8.185, 95% confidence interval [CI]: 3.196–20.962; P = 0.005), preterm delivery (OR: 24.517, 95% CI: 6.985–86.049; P = 0.001), and birth weight <2500 g (OR: 6.460, 95% CI: 2.893–14.429; P = 0.005) were more common among BV-positive women. Posttreatment persistent BV infection was 25.0% with significantly higher PROM (OR: 18.21, 95% CI: 4.654–71.317; P = 0.001), preterm delivery (OR: 14.571, 95% CI: 4.138–51.308; P = 0.001), birth weight