Vaginal infection
linked to miscarriage
United Press International
Friday, December 6, 2002
LONDON, Dec 05, 2002 (United Press International via COMTEX) -- Pregnant women carrying an infection in the vagina called bacterial vaginosis could be at increased risk for miscarriage during the second trimester, a new study released Thursday concludes.
"Bacterial vaginosis was associated with miscarriage between 13 to 15 weeks" into the pregnancy, Phillip Hay, a senior lecturer at St. George's Hospital Medical School's department of genitourinary medicine and co-author of the study, told United Press International.
Bacterial vaginosis typically is caused by an imbalance in the bacteria in the vagina. Harmful vaginal bacteria, which generally are sparse under healthy circumstances, begin to flourish. The condition can cause pain, abnormal discharge, burning and a fish-like odor but some women might not have any indication they are infected.
The condition probably causes miscarriage by disrupting development of the fetus. "The baby gets overwhelmed by infection," Hay said. The condition also is linked with premature birth and infection following gynecologic surgery, he said.
The Centers for Disease Control and Prevention in Atlanta has reported bacterial vaginosis is one of the most common infections in women of childbearing age, with approximately 16 percent carrying it.
Antibiotics can treat the condition effectively and "treatment early in the course of pregnancy" can prevent the disease from causing miscarriage, "but that needs to be studied properly," Hay said.
If a woman shows no symptoms, however, the infection might go undetected. Most of the women in the study were not aware they were infected, Hay said. In addition, the condition often recurs
"so figuring out how to stop it from coming back is another challenge for us," he said.
In the study, which appears in the Dec. 7 issue of the British Medical Journal, Hay's team asked more than 1,200 pregnant
women in London, who were only a few weeks into their pregnancies, to perform a self-administered vaginal swab. By 16 weeks, 121 women had miscarried and 174 tested positive for bacterial vaginosis.
Those infected with bacterial vaginosis experienced a significantly higher risk of miscarriage at 13-15 weeks than those not infected.
"It is a pretty well-done study and the conclusions are valid," Tanmoy Mukherjee, associate director of the Mount Sinai School of Medicine fertility program, told UPI.
However, it should be taken in the context that most miscarriages occur during the first trimester due to genetic defects in the developing fetus, Mukherjee said. The study only addresses problems in the second trimester where only about 2 percent to 3 percent of pregnancies end in miscarriage. So bacterial vaginosis is not a major cause of miscarriage, he said.
Nevertheless, women and their physicians "should take this seriously," Mukherjee said, and it still needs to be determined whether screening and treating all pregnant women for this disease is beneficial. Antibiotics can have side effects and some cases of bacterial vaginosis clear up on their own, so the next step should be to take a closer look at this "just to see if instituting treatment for all women who test positive for bacterial vaginosis makes sense," he said.
(Reported by Steve Mitchell, UPI Medical Correspondent, in Washington)
Copyright 2002 by United Press International.
