The Association Between Abnormal Vaginal Flora and Cytological Evidence of HPV with Prematurity in High-Risk Pregnant Wom

Özet

OBJECTIVE: To evaluate the association between abnormal vaginal flora and cytological evidence of HPV with prematurity in high-risk pregnant women. STUDY DESIGN: A prospective cohort study was designed with high-risk pregnant women who deliv-ered singletons between 20-42 gestational weeks between January to November 2018. Vaginal speci-mens were collected to obtain material from the upper lateral vaginal vault and cervix for direct micro-scopic examination of vaginal contents and preparation of Gram-stained and pap smear slides. Potential determinants of infection were assessed using the chi-square test. Poisson regression was used to de-termine the prevalence ratio and 95% confidence interval of the association between the vaginal flora and cytology with prematurity and a p<0.05 was considered as statistical significance. RESULTS: A total of 68 pap smear and high vaginal swab samples were collected from high-risk preg-nant women with a mean age of 30.3 years. There were 26 (38.2%) cases of abnormal vaginal flora and 6 (8.8%) of HPV-induced cytological abnormalities. The preterm delivery rate was comparable between women with normal and abnormal vaginal flora (11.9% vs. 11.5%, prevalence ratio 1.0 [95% confidence interval: 0.8-1.2], aPR 1.0 [95% confidence interval: 0.8-1.2]) and between women with and without ab-normal cytology (16.7% vs. 11.3%, prevalence ratio 0.9 [95% confidence interval: 0.6-1.4], aPR 0.9 [95% confidence interval: 0.6-1.4]). CONCLUSIONS: We determined no association between abnormal cytology or altered vaginal flora in high-risk pregnancy in terms of overall preterm birth rate.