Objective To determine predictors of bacterial vaginosis (BV) and the level of three common BV-related microorganisms by racial group.
Methods Prospective cohort study of 1,886 pregnant women. BV was measured with Nugent’s Gram Stain criteria, smoking status with
urinalysis of cotinine levels, and stress with Cohen’s perceived stress scale.
Results 73% of the cohort were African-American and 37% were BV positive. Smoking, numerous sexual partners, and single status were
related to both BV positivity as well as higher levels of
Gardnerella ssp. among African-American pregnant women. Age and history of STD were associated with BV positivity, and history of STD
and insurance status were associated with
Gardnerella ssp. levels in non-African-American pregnant women. Contrary to prior research, perceived stress and douching were not associated
with BV positivity or the level of any of the BV-related microorganisms in this cohort.
Conclusions A greater number of modifiable, behavioral-related risk factors predicted BV and the level of BV-related microorganisms among
African-American compared to non-African-American pregnant women. A deeper understanding of predictors of BV and related microorganism
levels by racial group may help eliminate critical disparities with respect to BV positivity and adverse pregnancy outcomes,
including spontaneous preterm birth.
Keywords Bacterial vaginosis -
Gardnerella ssp. -
Mobiluncus ssp. - Pregnancy - Racial disparities