The impact of bacterial vaginosis on pregnancy

Abstract

Bacterial vaginosis (BV) causes an imbalance in the vaginal microbiome whereby the native lactobacilli are superseded by pathogenic, anaerobic microorganisms, resulting in infection. BV is predominantly propagated by Gardnerella vaginalis (G. vaginalis), a pleomorphic, gram-variable coccobacillus, and, to a lesser extent, other BV-associated bacteria (BVAB). BV can be symptomatic or asymptomatic in patients, a criterion that necessitates the urgency for proper diagnosis and treatment, particularly during pregnancy. BV during pregnancy leads to sequelae of adverse obstetric outcomes, including preterm birth (PTB), pelvic inflammatory disease (PID), spontaneous miscarriage, susceptibility to sexually transmitted infections (STIs) and human immunodeficiency virus (HIV), and neonatal morbidity and mortality. Risk factors for BV include early sexual debut, unmarried status, uncircumcised partners, and a lack of condom use, amongst others. Neonatal complications involve low birth weight (LBW), neurological impairment, and respiratory distress. Little is known about these infections in sub-Saharan Africa (SSA). Consequently, this review aims to fill in the gaps in the literature. Given the enormous threat to public health and female reproductive health in South Africa (SA), demands for strategic and effective management plans are warranted to minimise the risk of developing BV.