1. ¹Department of Obstetrics and Gynecology, School of Medicine, University of Virginia, Charlottesville, VA, USA
2. ²Department of Health Evaluation Sciences, Pennsylvania State University, Hershey, PA, USA
3. ³Wake County Human Services, Raleigh, NC, USA
4. ⁴Catawba Valley Medical Center, Hickory, NC, USA
5. ⁵Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel Hill, NC, USA

Correspondence: Lisa M. Pastore, PhD, OB/GYN Department, Box 800712, University of Virginia, Charlottesville, VA 22908-0712, USA

⁶Affiliation of L.M.P. at the time of the research: School of Public Health, University of North Carolina, Chapel Hill, NC, USA.

⁷Affiliation of A.H. at the time of the research: Catawba County Health Department, Hickory, NC, USA.

Abstract

OBJECTIVE: Prospectively validate an antenatal bacterial vaginosis (BV) risk score at two public health department obstetrics clinics.

STUDY DESIGN: Women (n=409) entering prenatal care received a BV risk score (range 0 to 16) at their first visit and at 24 to 28 weeks' gestation. BV was measured with Gram-stained vaginal smears. Normal discharge was used as a surrogate for being asymptomatic.

RESULTS: Approximately half of the women scored 3 at each assessment. In total 29% had true BV at the first assessment (13% at the second assessment). The BV risk score (3) had 91% sensitivity and 63% specificity, and the BV risk score (5) had 88% sensitivity and 76% specificity. Among true cases, 42% were asymptomatic, of which 77% had risk scores 3. All symptomatic BV cases had risk scores 3.

CONCLUSION: In practice, the risk score identified both asymptomatic and symptomatic cases. Asymptomatic women are of particular interest because they are not screened for BV under current practice guidelines.