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Clinical and subclinical bacterial vaginosis before conception are associated with spontaneous abortion: a population-based retrospective cohort study
  • +19
  • Long Wang,
  • Jiaxin Huang,
  • Ying Yang,
  • Wenlu Xie,
  • Siyu Wu,
  • Jueming Lei,
  • Hanbin Wu,
  • Xinyi Lyu,
  • Chuanyu Zhao,
  • Meiya Liu,
  • Youhong Liu,
  • Die Xu,
  • Ya Zhang,
  • Hongguang Zhang,
  • Yuan He,
  • Zuoqi Peng,
  • Yuanyuan Wang,
  • Haiping Shen,
  • Qiaomei Wang,
  • Yiping Zhang,
  • Donghai Yan,
  • Xu Ma
Long Wang
Lanzhou University School of Public Health

Corresponding Author:[email protected]

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Jiaxin Huang
Lanzhou University School of Public Health
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Ying Yang
National Research Institute for Family Planning
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Wenlu Xie
Lanzhou University School of Public Health
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Siyu Wu
Lanzhou University School of Public Health
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Jueming Lei
National Research Institute for Family Planning
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Hanbin Wu
National Research Institute for Family Planning
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Xinyi Lyu
National Research Institute for Family Planning
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Chuanyu Zhao
National Research Institute for Family Planning
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Meiya Liu
Lanzhou University School of Public Health
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Youhong Liu
Lanzhou University School of Public Health
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Die Xu
Lanzhou University School of Public Health
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Ya Zhang
National Research Institute for Family Planning
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Hongguang Zhang
National Research Institute for Family Planning
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Yuan He
National Research Institute for Family Planning
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Zuoqi Peng
National Research Institute for Family Planning
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Yuanyuan Wang
National Research Institute for Family Planning
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Haiping Shen
National Health Commission of the People's Republic of China
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Qiaomei Wang
National Health Commission of the People's Republic of China
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Yiping Zhang
National Health Commission of the People's Republic of China
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Donghai Yan
National Health Commission of the People's Republic of China
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Xu Ma
National Research Institute for Family Planning
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Abstract

Objective To explore the association of clinical and subclinical bacterial vaginosis before conception with the risk of spontaneous abortion. Design Retrospective cohort study. Setting Mainland China. Population This study included women who enrolled in and completed the National Free Pre-Pregnancy Checkups Project between January 1, 2014 and December 31, 2018. Methods Clinical bacterial vaginosis before conception was diagnosed according to the Amsel criteria, and subclinical bacterial vaginosis before conception was defined as any indicators in the Amsel Criteria being positive but not meeting the diagnostic criteria. Analyses were performed by multivaribale-adjusted logistic models with crude and multivaribale-adjusted odds ratios including 95% confidence interval. Main outcome measures Spontaneous abortion was defined as fetal death occurring spontaneously before the 28th week of gestation. Results Of the included participants, 0.27% and 6.97% of them had clinical and subclinical bacterial vaginosis before conception respectively. A significantly increased risk of spontaneous abortion was observed for women with preconception bacterial vaginosis (OR: 1.19, 95% CI: 1.06-1.34). After excluding participants with preconception bacterial vaginosis, subclinical bacterial vaginosis was associated with a 15% (13%-18%) increased risk of spontaneous abortion. And the corresponding multivariable-adjusted ORs of exposure to abnormal vaginal discharge characteristics, vaginal pH value ≥4.5, positive clue cell test, and positive Whiff test for spontaneous abortion were 1.20 (1.03-1.39), 1.15 (1.12-1.18), 1.08 (0.97-1.19), and 1.24 (1.11-1.38). Conclusion Both clinical and subclinical bacterial vaginosis before conception were prospectively associated with an increased risk of spontaneous abortion.