Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Prospective Validation of a Perinatal Bacterial Vaginosis Screening Risk Score

Journal of Perinatology volume 24, pages 735–742 (2004)Cite this article

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.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2
Figure 3

Similar content being viewed by others

References

  1. Hill GB . The microbiology of bacterial vaginosis. Am J Obstet Gynecol 1993;169:450–454.

    Article  CAS  Google Scholar 

  2. McGregor JA, French JI . Bacterial vaginosis in pregnancy. Obstet Gynecol Surv 2000;55(5 Suppl 1):S1–S19.

    Article  CAS  Google Scholar 

  3. Amsel R, Totten PA, Spiegel CA, Chen KC, Eschenbach D, Holmes KK . Nonspecific vaginitis. Diagnostic criteria and microbial and epidemiologic associations. Am J Med 1983;74(1):14–22.

    CAS  PubMed  Google Scholar 

  4. Eschenbach D, Hillier SL, Critchlow C, Stevens C, DeRouen T, Holmes KK . Diagnosis and clinical manifestations of bacterial vaginosis. Am J Obstet Gynecol 1988;158:819–828.

    Article  CAS  Google Scholar 

  5. Nelson D, Macones G . Bacterial vaginosis in pregnancy: current findings and future directions. Epidemiol Rev 2002;24(2):102–108.

    Article  Google Scholar 

  6. Carey JC, Klebanoff MA, Hauth JC, et al. Metronidazole to prevent preterm delivery in pregnant women with asymptomatic bacterial vaginosis. National Institute of Child Health and Human Development Network of Maternal-Fetal Medicine Units. [comment][summary for patients in Can Fam Physician. 2002;48:891-3; PMID: 12138871]. N Eng J Med 2000;342(8):534–540.

    Article  CAS  Google Scholar 

  7. Taha TE, Hoover DR, Dallabetta GA, et al. Bacterial vaginosis and disturbances of vaginal flora: association with increased acquisition of HIV. AIDS 1998;12(13):1699–1706.

    Article  CAS  Google Scholar 

  8. Mastrobattista JM, Bishop KD, Newton ER . Wet smear compared with gram stain diagnosis of bacterial vaginosis in asymptomatic pregnant women. [comment]. Obstet Gynecol 2000;96(4):504–506.

    CAS  PubMed  Google Scholar 

  9. Nugent RPKM, Hillier SL . Reliability of diagnosing bacterial vaginosis is improved by a standardized method of Gram stain interpretation. J Clin Microbiol 1991;29(2):297–301.

    CAS  PubMed  PubMed Central  Google Scholar 

  10. Pastore LM, Thorp Jr. JM, Royce RA, Savitz DA, Jackson TP . Risk score for antenatal bacterial vaginosis: BV PIN points. J Perinatol 2002;22(2):125–132.

    Article  Google Scholar 

  11. Sackett DL, Haynes RB, Guyatt GH, Tugwell P . Clinical Epidemiology: A Basic Science for Clinical Medicine. 2nd ed. Boston: Little, Brown & Company, 1991.

    Google Scholar 

  12. Hay P, Morgan D, Ison C, et al. A longitudinal study of bacterial vaginosis during pregnancy. Br J Obstet Gynaecol 1994;101(12):1048–1053.

    Article  CAS  Google Scholar 

  13. Berg AO . Screening for bacterial vaginosis in pregnancy. Recommendations and rationale. Am J Prev Med 2001;20(3 Suppl):59–61.

    Article  CAS  Google Scholar 

  14. Leitich H, Bodner-Adler B, Brumbauer M, Kaider A, Egarter C, Husslein P . Bacterial vaginosis as a risk factor for preterm delivery: a meta-analysis. Am J Obstet Gynecol 2003;189(1):137–147.

    Article  Google Scholar 

  15. Krohn M, Hillier SL, Nugent RP . The genital flora of women with intraamniotic infection. J Infect Dis 1995;171:1475–1480.

    Article  CAS  Google Scholar 

  16. Watts DH, Krohn M, Hillier SL . Bacterial vaginosis as a risk factor for postcesarean endometritis. Obstet Gynecol 1990;75:52–58.

    CAS  PubMed  Google Scholar 

  17. Koumans EH, Kendrick JS . Preventing adverse sequelae of bacterial vaginosis: a public health program and research agenda. Sex Transm Dis 2001;28(5):292–297.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

We thank Elizabeth Bumgarner for her research assistance, Mary Otterness for her programming assistance, Tara Patton for medical record abstraction, and Dr Dana Redick for her helpful suggestions on the manuscript. Gram staining was provided gratis by LabCorp of America in Burlington, NC.

Author information

Author notes

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

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

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, School of Medicine, University of Virginia, Charlottesville, VA, USA

    Lisa M Pastore PhD

  2. Department of Health Evaluation Sciences, Pennsylvania State University, Hershey, PA, USA

    Tonya S King PhD

  3. Wake County Human Services, Raleigh, NC, USA

    Ida J Dawson MHA

  4. Catawba Valley Medical Center, Hickory, NC, USA

    Alisa Hollifield MHA

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

    John M Thorp Jr MD

Authors
  1. Lisa M Pastore PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tonya S King PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ida J Dawson MHA
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Alisa Hollifield MHA
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. John M Thorp Jr MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

This work was financially supported by the North Carolina Health Start Foundation.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Pastore, L., King, T., Dawson, I. et al. Prospective Validation of a Perinatal Bacterial Vaginosis Screening Risk Score. J Perinatol 24, 735–742 (2004). https://doi.org/10.1038/sj.jp.7211179

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.jp.7211179

This article is cited by

Search

Advanced search

Quick links