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Bacterial vaginosis. Transmission, role in genital tract infection and pregnancy outcome: an enigma.
APMIS. 2005 Apr; 113(4):233-45.A

Abstract

Whether bacterial vaginosis (BV) is acquired from an endogenous or an exogenous source is subject to controversy. Despite findings of an association between sexual behaviour and BV, some data indicate that BV is not a sexually transmitted infection in the traditional sense, while other data indicate that BV is an exogenous infection. A third aspect of BV is its tendency to go unnoticed by affected women. All of this will have a strong impact on how physicians view the risks of asymptomatic BV. This review focuses on whether or not BV should be regarded as a sexually transmitted infection (STI), its role in postoperative infections and pelvic inflammatory disease (PID), and on whether or not treatment of BV during pregnancy to reduce preterm delivery should be recommended. The reviewed studies do not lend unequivocal support to an endogenous or exogenous transmission of the bacteria present in BV. For women undergoing gynaecological surgery such as therapeutic abortion, the relative risk of postoperative infection is clearly elevated (approx. 2.3-2.8). A weaker association exists between BV and pelvic inflammatory disease. Data on treatment of BV as a way of reducing preterm delivery are inconclusive and do not support recommendations for general treatment of BV during pregnancy. The discrepant associations between BV and preterm birth found in recent studies may be explained by variations in immunological response to BV. Genetic polymorphism in the cytokine response--both regarding the TNF alleles and in interleukin production--could make women more or less susceptible to BV, causing different risks of preterm birth. Thus, studies on the vaginal inflammatory response to microbial colonization should be given priority.

Authors+Show Affiliations

Department of Molecular and Clinical Medicine, Linköping University, Linköping, Sweden. p-g.larsson@vgregion.seNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

15865604

Citation

Larsson, P G., et al. "Bacterial Vaginosis. Transmission, Role in Genital Tract Infection and Pregnancy Outcome: an Enigma." APMIS : Acta Pathologica, Microbiologica, Et Immunologica Scandinavica, vol. 113, no. 4, 2005, pp. 233-45.
Larsson PG, Bergström M, Forsum U, et al. Bacterial vaginosis. Transmission, role in genital tract infection and pregnancy outcome: an enigma. APMIS. 2005;113(4):233-45.
Larsson, P. G., Bergström, M., Forsum, U., Jacobsson, B., Strand, A., & Wölner-Hanssen, P. (2005). Bacterial vaginosis. Transmission, role in genital tract infection and pregnancy outcome: an enigma. APMIS : Acta Pathologica, Microbiologica, Et Immunologica Scandinavica, 113(4), 233-45.
Larsson PG, et al. Bacterial Vaginosis. Transmission, Role in Genital Tract Infection and Pregnancy Outcome: an Enigma. APMIS. 2005;113(4):233-45. PubMed PMID: 15865604.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Bacterial vaginosis. Transmission, role in genital tract infection and pregnancy outcome: an enigma. AU - Larsson,P G, AU - Bergström,M, AU - Forsum,U, AU - Jacobsson,B, AU - Strand,A, AU - Wölner-Hanssen,P, PY - 2005/5/4/pubmed PY - 2005/6/7/medline PY - 2005/5/4/entrez SP - 233 EP - 45 JF - APMIS : acta pathologica, microbiologica, et immunologica Scandinavica JO - APMIS VL - 113 IS - 4 N2 - Whether bacterial vaginosis (BV) is acquired from an endogenous or an exogenous source is subject to controversy. Despite findings of an association between sexual behaviour and BV, some data indicate that BV is not a sexually transmitted infection in the traditional sense, while other data indicate that BV is an exogenous infection. A third aspect of BV is its tendency to go unnoticed by affected women. All of this will have a strong impact on how physicians view the risks of asymptomatic BV. This review focuses on whether or not BV should be regarded as a sexually transmitted infection (STI), its role in postoperative infections and pelvic inflammatory disease (PID), and on whether or not treatment of BV during pregnancy to reduce preterm delivery should be recommended. The reviewed studies do not lend unequivocal support to an endogenous or exogenous transmission of the bacteria present in BV. For women undergoing gynaecological surgery such as therapeutic abortion, the relative risk of postoperative infection is clearly elevated (approx. 2.3-2.8). A weaker association exists between BV and pelvic inflammatory disease. Data on treatment of BV as a way of reducing preterm delivery are inconclusive and do not support recommendations for general treatment of BV during pregnancy. The discrepant associations between BV and preterm birth found in recent studies may be explained by variations in immunological response to BV. Genetic polymorphism in the cytokine response--both regarding the TNF alleles and in interleukin production--could make women more or less susceptible to BV, causing different risks of preterm birth. Thus, studies on the vaginal inflammatory response to microbial colonization should be given priority. SN - 0903-4641 UR - https://www.unboundmedicine.com/medline/citation/15865604/Bacterial_vaginosis__Transmission_role_in_genital_tract_infection_and_pregnancy_outcome:_an_enigma_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0903-4641&date=2005&volume=113&spage=233 DB - PRIME DP - Unbound Medicine ER -