Correlation of bacterial vaginosis with preterm labour: a case control study

Background: Bacterial vaginosis (BV) is thought to be an important risk factor and predictor of preterm labour. Prevention and early detection and treatment of BV can decrease the incidence of preterm labour. Primary objective of this study was to find out correlation of bacterial vaginosis with preterm labour. Secondary objectives were determination of most important criterion among the Amsels criteria and risk factors for BV among literacy, residence and parity.Methods: A Case-control study carried out at a tertiary care hospital in north India. 100 women with preterm labour and 200 women with term labour after fulfilling inclusion criteria were enrolled as cases and controls respectively. Epidemiological and clinical details were recorded. Bacterial vaginosis was diagnosed by Amsels criteria. Prevalence in both groups was calculated. Statistical analysis was then done to find out association between bacterial vaginosis and preterm labour.Results: Among all women enrolled 94 had bacterial vaginosis. The overall prevalence of bacterial vaginosis in both groups combined was 31.33%. It was 42% in cases and 26% in controls. The difference was statistically significant (p=0.007). Whiff test emerged as the strongest criterion if used alone with a sensitivity of 98% and specificity of 81% when compared to whole Amsels criteria. Bacterial vaginosis was found more in illiterate women and those who had given birth previously.Conclusions: Bacterial vaginosis is significantly more prevalent in women with preterm labour. Whiff test can be used alone in centres where the patient load is too high. Illiteracy is a risk factor that can be modified to bring down incidence of bacterial vaginosis