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Oluoch L, Tapia K, Kiptinness C, Casmir E, Maina SG, Makena L, Selke S, Wang M, Chohan B, Sycuro L, Wald A, Ngure K, Mugo N, Roxby A. Longitudinal assessment of bacterial vaginosis prior to and during incident pregnancy: an observational study in Kenyan adolescent girls and young women. BMJ Open 2023; 13:e071746. [PMID: 37813538 PMCID: PMC10565234 DOI: 10.1136/bmjopen-2023-071746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 09/11/2023] [Indexed: 10/13/2023] Open
Abstract
OBJECTIVE To determine bacterial vaginosis (BV) status at multiple time points among adolescent girls and young women (AGYW) and assess the impact of pregnancy on their BV status. DESIGN Longitudinal cohort study. SETTING Thika, Kenya. PARTICIPANTS AGYW aged 16-20 years enrolled prior to first sex or reporting only a single lifetime partner. MAIN OUTCOME MEASURES The primary outcome was relative risk (RR) of BV during pregnancy compared with before pregnancy by analysing longitudinal trends in BV over time. BV risk was estimated using Poisson regression models. RESULTS A total of 121 AGYW became pregnant in the parent cohort and had BV results before, during or after pregnancy. Point prevalence of BV was 11.0% at visits >12 months pre-pregnancy, 13.0% at 3-12 months pre-pregnancy, 22.1% at <3 months pre-pregnancy and 13.4% during pregnancy. Compared with visits during pregnancy, RR of BV was 1.65 (95% CI: 1.00 to 2.71; p=0.05) at visits <3 months pre-pregnancy, 0.97 (95% CI: 0.62 to 1.52; p=0.90) at visits 3-12 months pre-pregnancy and 0.82 (95% CI: 0.44 to 1.53; p=0.53) at visits 12 months pre-pregnancy. An adjusted analysis including age, income, residence, date of first sex, recent sexual activity and positive sexually transmitted infection test resulted in small changes in risk estimates, with adjusted RR of BV of 1.66 (95% CI: 1.04 to 2.67; p=0.04) at visits <3 months pre-pregnancy compared with visits during pregnancy. CONCLUSIONS BV risk during pregnancy was lower than during the immediate pre-pregnancy period. Hormonal changes in pregnancy may reduce BV.
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Affiliation(s)
- Lynda Oluoch
- Center for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya
| | - Kenneth Tapia
- Global Health, University of Washington, Seattle, Washington, USA
| | | | - Edinah Casmir
- Center for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya
| | | | - L Makena
- Kenya Medical Research Institute (KEMRI), Nairobi, Kenya
| | - Stacy Selke
- Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA
| | - Melody Wang
- Global Health, University of Washington, Seattle, Washington, USA
| | - Bhavna Chohan
- Center for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya
- Global Health, University of Washington, Seattle, Washington, USA
| | - Laura Sycuro
- Department of Microbiology, Immunology and Infectious Diseases; Obstetrics and Gynecology; Snyder Institute for Chronic Diseases; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
| | - Anna Wald
- Medicine, Laboratory Medicine and Pathology, Epidemiology, University of Washington, Seattle, Washington, USA
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Kenneth Ngure
- Community Health, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
| | - Nelly Mugo
- Center for Clinical Research, Kenya Medical Research Institute, Nairobi, Kenya
- Global Health, University of Washington, Seattle, Washington, USA
| | - Alison Roxby
- Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
- Global Health, Medicine, Epidemiology, University of Washington, Seattle, Washington, USA
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Sun C, Zhou R, Yang L. Biostatistics Health Assessment of Matrix Metalloproteinases in Vaginal Secretions in Late Pregnant Women. JOURNAL OF MEDICAL IMAGING AND HEALTH INFORMATICS 2021. [DOI: 10.1166/jmihi.2021.3815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Objective: The health management of pregnant women in late pregnancy is difficult. Once vaginal infection occurs, adverse pregnancy outcomes will occur. The aim of this study was to explore the application value of biostatistics health assessment of matrix metalloproteinases
(MMP) in vaginal secretions in late pregnant women with vaginal infection. Methods: A total of 120 late pregnant women with vaginal infection, including vulvovaginal candidiasis (WC) in 70 cases and bacterial vaginosis (BV) in 50 cases, were selected as the experimental group. Another
80 pregnant women with normal vaginal secretion in the same gestational week were randomly selected as the control group. Vaginal soft capsule of mycomycin was used in the treatment. The expression levels of MMP-8 and MMP-9 in vaginal secretions before and after treatment were detected by
enzyme-linked immunosorbent assay (ELISA) and smear immunohistochemistry, Results: Both the ELISA and immunohistochemistry analysis showed that the levels of MMP-8 and MMP-9 in the vaginal secretion of experimental group were significantly increased than the data of control group (P
< 0.05). After effective intervention, the levels of MMP-8 and MMP-9 were significantly lower than those before treatment (P < 0.05). Conclusion: The late pregnant women with vaginal infection was accompanied by the high level of MMP-8 and MMP-9 in vaginal secretions. Effective
intervention will lead the reduction of MMP. Thus, the biostatistics health assessment of MMP is important for the late pregnant women with vaginal infection.
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Affiliation(s)
- Chuanming Sun
- Department of Obstetrics and Gynecology, The Third People's Hospital of Hefei, Anhui Hefei 230022, China
| | - Rongsheng Zhou
- Department of Obstetrics and Gynecology, The Third People's Hospital of Hefei, Anhui Hefei 230022, China
| | - Lihua Yang
- Department of Obstetrics and Gynecology, The Third People's Hospital of Hefei, Anhui Hefei 230022, China
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