Impact of Bacterial Vaginosis on Perineal Tears during Delivery: A Prospective Cohort Study

Vincent Letouzey, Sophie Bastide, Daniela Ulrich, Laurie Beccera, Mariella Lomma, Renaud de Tayrac, Jean Philippe Lavigne, Vincent Letouzey, Sophie Bastide, Daniela Ulrich, Laurie Beccera, Mariella Lomma, Renaud de Tayrac, Jean Philippe Lavigne

Abstract

Objective: Long term effects of perineal tears pose a major worldwide health issue for women during delivery. Since bacterial vaginosis is related to major obstacles in obstetrics the aim of this study was to determine the relationship between bacterial vaginosis and the occurrence of perineal tears during vaginal delivery.

Methods: Between June 2013 and December 2013 pregnant women delivering after 37 weeks were recruited at one University hospital / tertiary care referral center in the course of this single-center, prospective cohort study. Bacterial vaginosis was assessed according to Nugent score method. Logistic-regression model was used to estimate odds ratios, adjusted for other risk factors to test the relationship between bacterial vaginosis and the occurrence of 1st to 4th degree perineal tears in women undergoing vaginal delivery.

Results: A total of 728 woman were included, 662 analyzed with a complete Nugent Score of the vaginal swab. The prevalence of 1st to 4th degree perineal tears was 35.8% (95% Confidence Interval (95%CI) = [32.2; 39.6]). The presence of BV was not significantly associated to the incidence of perineal tears neither in the univariate analysis (crude Odds Ratio = 1.43; 95%CI = [0.79; 2.60]; p = 0.235) nor in the multivariate analysis (adjusted Odds Ratio = 1.65; 95%CI = [0.81; 3.36]; p = 0.167). Instrumental delivery was the most important risk factor for perineal lacerations.

Conclusions: There is no evidence that vaginosis is a risk factor for vaginal tears.

Trial registration: ClinicalTrials.gov N° NCT01822782.

Conflict of interest statement

Competing Interests: All authors except RdT have declared that no competing interests exist. Renaud de Tayrac is a consultant for Boston Scientific and Coloplast. The authors confirm that this does not alter their adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1. Flowchart describing the study population.
Fig 1. Flowchart describing the study population.

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