Background Bacterial vaginosis (BV) is the most common lower genital tract infection among women of reproductive age and has been consistently associated with adverse pregnancy outcomes. During pregnancy, disruption of the normal Lactobacillus-dominant vaginal flora may predispose women to ascending infections, increasing the risk of preterm premature rupture of membranes (PPROM) and preterm labour (PTL). Objective The present study aimed to assess the prevalence of bacterial vaginosis among antenatal women between 18 and 24 weeks of gestation and to evaluate its association with preterm premature rupture of membranes (PPROM), preterm labour (PTL), and early neonatal outcomes, including birth weight, Apgar scores at 1 and 5 minutes, and neonatal ICU (NICU) admission by estimating relative risks (RRs) and corresponding 95% confidence intervals for adverse maternal and neonatal outcomes. Additionally, the study aims to explore the potential clinical relevance of bacterial vaginosis as a risk marker for adverse pregnancy outcomes within the context of an observational cohort design. Methods This prospective observational cohort study included 220 antenatal women with singleton pregnancies between 18 and 24 weeks of gestation attending a tertiary care hospital. Participants were screened for BV using vaginal pH testing, whiff test, wet mount microscopy, Gram staining, and Nugent scoring. Women were followed until delivery, and maternal outcomes (PPROM, PTL, gestational age at delivery) and neonatal outcomes (birth weight, Apgar scores, NICU admission) were recorded. Statistical analysis was performed using Student’s t-test and Chi-square/Fisher’s exact test, with a p-value <0.05 considered statistically significant. The study was conducted from May 2023 to April 2025, and statistical analysis was performed using SPSS version 25.0 (IBM Corp., Armonk, USA). Results The prevalence of BV was 110/220 (50%). PPROM occurred in 27/110 (24.5%) of BV-positive women compared to 3.6% of BV-negative women (RR = 6.8; p < 0.001). Preterm labour was observed in 23/110 (20.9%) of BV-positive women versus 4/110 (3.6%) in BV-negative women (RR = 5.8; p < 0.001). BV-positive women delivered at a significantly lower mean gestational age. Neonates born to BV-positive mothers had significantly higher rates of low Apgar scores at 1 minute, 86/110 (78.2%) vs 61/110 (55.5%), and 5 minutes, 48/110 (43.6%) vs 20/110 (18.2%), p < 0.001. Conclusions Bacterial vaginosis was highly prevalent in mid-pregnancy and showed a strong association with PPROM, PTL, and adverse early neonatal outcomes. Routine screening for BV between 18 and 24 weeks of gestation may help identify women at risk and potentially reduce preterm birth-related morbidity.
Mukherjee et al. (Fri,) studied this question.