Profiling of Bacteria in Bacterial Vaginosis Infection Among Preterm Births in Kisumu County

Abstract

Background: Preterm birth (PTB) is defined as a live birth (singleton or multiple) before 37 weeks of completed gestation. PTB is the topmost cause of morbidity and death of pretem babies internationally and the second foremost cause of death for children below five years globally. In spite the determinations to avoid PTB in most nations the incidence of PTB has been on the rise. Common causes of PTB include multiple fetal, infections, genetic influence and chronic diseases such diabetes and hypertension. Among the infectious agents, bacteria attribute to the largest number of microorganisms associated with preterm births. The most prevalent lower genital infection that causes pre-term births is bacterial vaginosis and several researches have shown a positive association between the two. This study therefore highlights the profile of bacteria associated with BV related with pre-term birth in Kisumu County. Broad Objective: To profile bacteria associated with bacterial vaginosis related to preterm deliveries in Kisumu County Hospital. Methodology: This was a comparative study conducted in Kisumu County. The study population included expectant women recruited at Kisumu County hospital. A vaginal specimen was collected from the study participants. The specimen was run through Amsel and Nugent score laboratory diagnostic test to determine the BV status of the study participants. In addition identification of different bacteria was done under Nugent scoring. A pre-tested questionnaire was used to collect risk factors. Analysis was done using SPSS version 20. Results: Of the 228 pregnant women were enrolled in the study, 181 study participants had complete data thus could be categorized if they delivered at term or preterm. Last menstruation Period (LMP) and ultra-sound (Ultra-s) were used to determine gestational age. Of the 181 who had LMP results, 64 had ultra-S. BV prevalence based on LMP was found to be 12% (22/181). Gardenerella vaginalis/Bacteroides were dominant among bacterial vaginosis (BV) positive with a frequency of 50% in both term and preterm under LMP. However under ultra-S a frequency of 46% and 55% was recorded among term and preterm respectively. Risk factors that were significant under ultra-S were age 31-40 (p=0.002), use of nylon panty material (p=0.045), history of PTB (p=0.049), condom use in the last sexual act (p=0.022), parity 3+0 (p=0.013), parity 4+0 (p=0.003, gravidae 1 and 2 (p=0.034 and 0.001) respectively. Under LMP hormonal and nonhormonal contraceptive (p=0.046) and parity (p=0.031) were significant. Conclusion: The dominant bacteria were G.vaginalis/Bacteroides in both term and preterm deliveries, under BV positives and the frequencies were slightly higher among PTB in ultra-S. Key words: Bacterial vaginosis and preterm birth