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Risk Score for Antenatal Bacterial Vaginosis: BV PIN Points

Journal of Perinatology volume 22, pages 125–132 (2002)Cite this article

Abstract

OBJECTIVE: Develop a clinical risk score to screen for antenatal bacterial vaginosis (BV), irrespective of symptoms.

STUDY DESIGN: Cohort study of 913 pregnant women with last menstrual periods between January 30, 1995 and February 22, 1997. BV was evaluated by Nugent-scored vaginal smears (scores of 7 to 10 considered positive) between 24 and 29 weeks' gestation. Forty-four potential risk factors were assessed.

RESULTS: 17.8% of women had BV, of whom 22% were screened for BV by the usual care provider. Logistic regression–adjusted analyses found six predictors: vaginal pH>4.5 (OR=11.6, 95% confidence interval [CI] [7.8, 17.2]); black race (OR=1.9, 95% CI [1.3, 2.8]); condom use during pregnancy (OR=1.6, 95% CI [1.0, 2.5]); antenatal BV (OR=1.7, 95% CI [1.0, 2.8]); absence of sperm on smear (OR=1.7, 95% CI [1.0, 2.9]); and no history of sexually transmitted diseases (OR=1.6, 95% CI [1.0, 2.5]). Risk score weights were 5 for an elevated vaginal pH and 1 otherwise. The sensitivity and specificity of screening women with scores ≥4 were both 77%; this would involve screening 33% of patients.

CONCLUSION: Approximately 80% of our BV cases were asymptomatic, emphasizing the need for objective risk assessment. Using six factors, clinicians can identify pregnant women at risk for BV.

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Acknowledgements

We thank Laboratory Corporation of America (Burlington, NC) for Gram staining. We thank the PIN Study staff: project manager, Jude F. Williams; interviewer coordinator, Teresa Sanfelippo; and the clinic site coordinators, Barbara Eucker and Anne Carter. Statistical programming assistance was provided by Quinhong Yang. We greatly appreciate the cooperation of the clinic staff, particularly, Peter Morris, Ida Dawson, Cathi Weatherly-Jones, Juan Granados, Thad McDonald, and Sara Caviness.

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Authors and Affiliations

  1. Department of Epidemiology, School of Public Health, University of North Carolina, Chapel Hill, NC, USA

    Lisa M Pastore PhD, Rachel A Royce PhD & David A Savitz PhD

  2. Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina, Chapel Hill, NC, USA

    John M Thorp Jr MD & Tracy P Jackson

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  1. Lisa M Pastore PhD
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Additional information

This study was supported by the North Carolina Healthy Start Foundation; grant HD28684 from the National Institute of Child Health and Human Development, National Institutes of Health; cooperative agreements S455-16/16-17 through the Association of Schools of Public Health/Centers for Disease Control and Prevention, U64/CCU412273 through the Centers for Disease Control and Prevention; and funds from the Wake Area Health Education Center in Raleigh, NC, USA.

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Pastore, L., Thorp, J., Royce, R. et al. Risk Score for Antenatal Bacterial Vaginosis: BV PIN Points. J Perinatol 22, 125–132 (2002). https://doi.org/10.1038/sj.jp.7210654

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