Prevalence of bacterial vaginosis in pregnant and non-pregnant Iranian women: a systematic review and meta-analysis
- 69 Downloads
Bacterial vaginosis (BV) is a vaginal disorder which occurs either symptomatic or asymptomatic because of an imbalance between H2O2-producing Lactobacillus and Gardnerella vaginalis in the vagina. This systematic review and meta-analysis is the first to determine the prevalence of BV in pregnant and non-pregnant women in Iran.
We used national (SID, Irandoc, Iranmedex and Magiran) and international (PubMed, Scopus, Google Scholar and ISI web of knowledge) electronic databases to systematically search and collect available studies using related keywords (up to 1 December 2017). Inclusion and exclusion criteria were defined to select eligible studies.
The overall prevalence of BV among Iranian women was 18.9% (95% CI 14–25). Gardnerella vaginalis was the most prevalent isolated bacteria. The prevalence of BV in non-pregnant women was 28% (95% CI 15.1–45.9) which was higher compared with pregnant women who had a prevalence of 16.5% (95% CI 12.5–21.6).
The present review revealed a high prevalence of BV in non-pregnant women. Given that BV is associated with a series of reproductive complications such as infertility, taking preventive measures such as awareness of patients as well as monitoring and controlling of syndrome are essential.
KeywordsBacterial vaginosis Pregnant women Non-pregnant women Iran
SS: Data collection, MA: Manuscript editing, HV: Data collection and manuscript editing, GR: Project guide, AS: Manuscript editing, FK: Data collection and analysis and manuscript writing.
Compliance with ethical standards
Conflict of interest
There is no conflict of interest.
- 4.Krauss-Silva L, Almada-Horta A, Alves MB, Camacho KG, Moreira MEL, Braga A (2014) Basic vaginal pH, bacterial vaginosis and aerobic vaginitis: prevalence in early pregnancy and risk of spontaneous preterm delivery, a prospective study in a low socioeconomic and multiethnic South American population. BMC Pregnancy Childbirth 14(1):1–10CrossRefGoogle Scholar
- 7.Moreira Mascarenhas RE, Sacramento Cunha Machado M, da Borges e Silva BF, Fernandes Weyll Pimentel R, Teixeira Ferreira T, Silva Leoni FM et al (2012) Prevalence and risk factors for bacterial vaginosis and other vulvovaginitis in a population of sexually active adolescents from Salvador, Bahia, Brazil. Infect Dis Obstet Gynecol 2012:1–6CrossRefGoogle Scholar
- 10.Beverly ES, Chen HY, Wang QJ, Zariffard MR, Cohen MH, Spear GT (2005) Utility of Amsel criteria, Nugent score, and quantitative PCR for Gardnerella vaginalis, Mycoplasma hominis, and Lactobacillus spp. for diagnosis of bacterial vaginosis in human immunodeficiency virus-infected women. J Clin Microbiol 43(9):4607–4612CrossRefGoogle Scholar
- 16.Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP et al (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med 6(7):e1000100CrossRefPubMedPubMedCentralGoogle Scholar
- 17.Ramezani Tehrani F, Farahmand M, Abedini M, Hashemi Z (2012) Prevalence of vaginitis in Iranian women-symptoms and clinical association (Persian). Med Sci J 22(1):62–68Google Scholar
- 21.Kazamzadeh M, Kashanian M, Sedaghat M (2010) Evaluation and comparison of the pathogenic agents and risk factors of bacterial vaginosis (Persian). Iran J Obst Gynecol Infertil 13(4):9–13Google Scholar
- 22.Barouti E, Farzaneh F, Sene AA, Tajik Z, Jafari B (2013) The pathogenic microorganisms in papanicolaou vaginal smears and correlation with inflammation. J Fam Reprod Health 7(1):23–27Google Scholar
- 24.Salehian M, Mozaffari NA, Foroohesh Tehrani H (2008) Antibiotic resistance of Gardnerella vaginalis in patients with bacterial vaginosis against Metronidazole and Clindamycin (Persian). Iran J Infect Dis Trop Med 13(42):43–47Google Scholar
- 25.Ganji L, Amirmozaffari N, Akbarian A, Ynesi S, Ghelman M (2011) The incidence of co-occurrence of chlamydial cervicitis with bacterial vaginosis (Persian). Qom Univ Med Sci J 5(1):3–6Google Scholar
- 27.Afrakhteh M, Mahdavi A, Afrakhteh M (2007) Bacterial vaginosis and urinary tract infection. J Obstet Gynecol India 57:513–516Google Scholar
- 28.Akbarian AR, Akhlaghi L, Ourmazdi H, Foroohesh H, Falahati M, Farokhnejad R (2005) An investigation on coincidence of trichomoniasis and bacterial vaginosis and their effects on pregnant women referred to Shahid Akbarabadi Maternity Hospital in Tehran during 2002–2003 (Persian). Razi J Med Sci 12(46):227–234Google Scholar
- 29.Farajzadeh shikh A, Hemati Y (1997) Study of the prevalence of Gardnerella vaginalis isolated from vaginal discharges of patients referred to outpatient clinic of Taleghani hospital in Tehran (Persian). J Kerman Univ Med Sci 5(2):92–98Google Scholar
- 30.Ghazisaeidi K, Ghaemi E (1993) The comparative study of Gardenerella vaginalis in healthy women and in patient with bacterial vaginosis (Persian). Tehran Univ Med J 51:74–79Google Scholar
- 31.Ivanbagha R, Soroush Barhaghi MT, Babapour J, Fathi S (2011) Risk factors and clinical findings of Gardnerella vaginalis infection in women referring to Tabriz health centers(Persian). Med Sci J 21(3):214–221Google Scholar
- 33.Moniri R, Behrashi M (2009) Effects of metronidazole therapy on preterm labor in women. Acta Med Iran 47(3):181–184Google Scholar
- 34.Tavana Z, Zolghadri J, Hadaiegh M, Pourdast T (2010) The effect of treatment of bacterial vaginosis on pregnancy outcome (Persian). Iran J Obstet Gynecol Infertil 13(5):1–7Google Scholar
- 35.Zargar Shoushtari S, Sarrafi A, Makvandi S (2016) Evaluating the pap smear reports of pathology laboratories in Ahvaz, Iran. J Midwifery Reprod Health 4(3):689–695Google Scholar
- 36.Makvandi S, Zargar Shoushtari S (2012) The relationship of cervicovaginal infections in pap smear samples with some factors in Ahvaz, Iran; an epidemiological study (Persian). Jundishapur J Chronic Dis Care 1(1):e32247Google Scholar
- 37.Shahinfar S, Noman Pour B (2015) The relationship between various individual characteristics and common vaginal infections among the women referring to Payambar Azam gynecology clinic in Kerman city (Persian). Iran J Obstet Gynecol Infertil 18(148):10–17Google Scholar
- 39.Ashraf-Ganjui T, Shahabi M (2003) Epidemiology and risk factors of bacterial vaginosis in women visiting the gynecologic clinic of Bahonar Hospital of Kerman University of Medical Sciences in 2002 (Persian). J Kerman Univ Med Sci 10(4):200–210Google Scholar
- 40.Golmohammadlou S, Behrooz lak T, Jafari R, Oshnui S, Pashapoor S (2013) Prevalence of bacterial vaginosis during pregnancy and related factors in Urmia district (Persian). J Urmia Univ Med Sci 24(5):347–354Google Scholar
- 41.Hajishafiha M, Salari Lac S, Khairi Tabar M, Naji S, Sadaghiani M, Asadi N (2011) Evaluation of relationship between bacterial vaginosis and embryo implantation and early abortion in infertile couple curing with intra cytoplasmic sperm injection (Persian). J Ardabil Univ Med Sci 11(1):33–42Google Scholar
- 42.Shobeiri F, Nazari M (2006) A prospective study of genital infections in Hamedan, Iran. Southeast Asian J Trop Med Public Health 20:14–19Google Scholar
- 43.Yousefi Mashouf R, Otougara M (2008) The frequency of prevotella species in women with bacterial vaginosis and detection of the drug resistance (Persian). Iran J Obstet Gynecol Infertil 11(2):7–14Google Scholar
- 46.Rahimi G, Etehad G, Tazakori Z (2011) Prevalence of bacterial vaginosis in pregnant women (Persian). J Health Care 13(1):1–5Google Scholar
- 47.Azargoon A, Darvishzadeh S (2006) Association of bacterial vaginosis, Trichomonas vaginalis, and vaginal acidity with outcome of pregnancy. Arch Iran Med 2006:213–217Google Scholar
- 49.Ziaei Hezarjaribi H, Dalimi A, Ghasemi M, Ghafari R, Esmaeili S, Armat S et al (2013) Prevalence of common sexually transmitted diseases among women referring for pap smear in Sari, Iran [Persian]. J Mazandaran Univ Med Sci 22(1):19–24Google Scholar
- 51.Molana K, Ghazi Saeidi K (2000) Frequency of Gardnerella vaginalis among pregnant and non-pregnant women referred to Babol University of Medical Sciences clinics in 1997 (Persian). J Gorgan Univ Med Sci 2(1):12–18Google Scholar
- 54.Taghriri A, Danesh A (2006) Bacterial vaginosis in patients referring to medical centers in Shahrekord, 2004–2005 [Persian]. Feyz J Kashan Univ Med Sci 9(4):31–35Google Scholar
- 55.Borjian S, Shojaei H, Shabanian M, Deris F (2002) Diagnosis of Gardnerella associated vaginosis in Borujen women’s outpatient Clinic, 2000 (Persian). J Shahrekord Univ Med Sci 3(4):38–44Google Scholar
- 56.Abotorabi S, Sharifi M, Javadi A, Mahram M, Soleimanian J (2012) Association between bacterial vaginosis and preterm delivery and birth-weight in infant (Persian). J Qazvin Univ Med Sci 16(2):16–20Google Scholar
- 57.Shahgeibi S, Seied-Al-Shohadaie F, Seied-Al-Shohadaie A, Ghaderi E (2009) Complications of bacterial vaginosis in pregnancy. Pak J Med Sci 25(6):953–956Google Scholar
- 58.Parhizkar S, Moshfe A (2003) Prevalence of cervicovaginal infections among the pap smears of women (Yasuj 1999–2000) (Persian). Armaghan Danesh 7(28):37–47Google Scholar
- 59.Yaghmaei M, Kalati F, Jahantigh M, Roudbari M, Soltani B (2009) Accuracy of Amsel’s criteria in the diagnosis of bacterial vaginosis (preliminary report) (Persian). Iran J Obstet Gynecol Infertil 12(3):17–22Google Scholar
- 64.Lata I, Pradeep Y, Sujata Jain A (2010) Estimation of the incidence of bacterial vaginosis and other vaginal infections and its consequences on Maternal/Fetal outcome in pregnant women attending an antenatal clinic in a Tertiary Care Hospital in North India. Indian J Community Med 35:285–289CrossRefPubMedPubMedCentralGoogle Scholar