Association between abnormal microbiological flora of the lower genital tract in early pregnancy and socio-economic, demographic and environmental risk factors

摘要

Background: The main aim of this study was to determine the socioeconomic, demographic and environmental factors which may be associated with the occurrence of pathological microflora of the lower genital tract in early pregnancy.Material and methods: A group of 96 pregnant women was selected at random from the patients of 10 district maternity units in the Lodz region of Poland. Only singleton pregnancies below 24 weeks were qualified for inclusion in the survey. A standard questionnaire covering medical, socio-economic, demographic, constitutional, and environmental items was administered to every subject and checked against medical records. Based on microbiological results, two groups of pregnant women were distinguished: Group I, with normal cervicovaginal flora, predominantly Lactobacillus spp. with coagulase-negative staphylococci and viridans streptococci, and Group II, with abnormal flora. The latter included two subgroups: IIA, intermediate microbial flora, dominated by M. hominis, U. urealyticum, G. vaginalis, gram-negative anaerobic rods, Ch. trachomatis, and few Lactobacillus spp, and IIB, highly abnormal flora, containing similar microbial components as in IIB but without Lactobacillus spp.Results: Based on the results of microbiological culturing, 18 (18.7%) of the 96 women examined were classified to Group I, and 78 (81.2%) to Group II: 32 (33.3%) in group IIA and 46 (47.9%) in IIB. Groups IIA and IIB were combined for further analysis. An excessive risk of abnormal vaginal flora was observed in connection with such socio-economic factors as marital status, unemployment, and smoking, Moreover, the first pregnancy was also found to be a potential risk factor for this pathology. The risk of developing abnormal vaginal flora, although exceeding unity for each of these factors, was not considered statistically significant.Conclusions: Socio-economic and environmental factors may influence the course and outcome of pregnancy. Pregnant women who present with risk factors for abnormal cervicovaginal microflora should be included in comprehensive prenatal surveillance, which enables early detection and treatment of this pathology.