The effects of vaginal infections on pregnancy outcomes: a retrospective cohort study in China.

Abstract

Background: This retrospective cohort study aimed to investigate the correlation between vaginal infections and adverse pregnancy outcomes in a Chinese obstetric population.

Methods: This study was conducted at the International Peace Maternity and Child Health Hospital in Shanghai from 2021 to 2023. The primary objective was to assess the incidence of various vaginal infections and their associations with preterm birth (PTB), low birth weight (LBW), and preterm premature rupture of membranes (PPROM). Data were collected from medical records, with vaginal infection diagnoses confirmed through standard laboratory procedures. This study included women who registered and delivered at our hospital between 2021 and 2023. Strict exclusion criteria were applied to control confounding factors, excluding women with a history of syphilis, human immunodeficiency virus infection, hepatitis virus infection, or non-live birth outcomes. Continuous variables were analyzed using the Mann-Whitney U test, whereas categorical variables were assessed using the Pearson chi-square test or Fisher exact test. Logistic regression analysis was employed for multivariate assessments to determine whether vaginal infections were independent risk factors for adverse pregnancy outcomes.

Results: Vaginal infections were significantly associated with adverse pregnancy outcomes. Women with vaginal infections had higher rates of PTB (15.65% vs. 9.16%, P < 0.001), LBW (10.82% vs. 5.93%, P < 0.001), and PPROM (7.41% vs. 5.31%, P < 0.001) compared with their uninfected counterparts. Mixed vaginitis demonstrated a stronger association with these adverse outcomes compared with single infections. The timing of infection during pregnancy emerged as a critical determinant of the risk of adverse outcomes.

Conclusions: The study underscores the critical need for comprehensive screening and management of vaginal infections during pregnancy to improve maternal and neonatal health. Targeted interventions, particularly in the later stages of pregnancy, are essential to mitigate the risks associated with vaginal infections. Future research should focus on developing more effective screening methods and therapeutic strategies to address the specific types of vaginal infections and their effects on pregnancy outcomes.