Women often question why they end up with premature babies, but in a new study, experts say that overwhelming vaginal infection in pregnancy may explain some cases of premature and low birthweight babies.
In the study, researchers said such an imbalance of naturally occurring bacteria found in a woman’s vagina can also predispose a woman to having a stillbirth.
The researchers at the Olabisi Onabanjo University Teaching Hospital (OOUTH), Sagamu, Ogun State had looked at how bacteria vaginosis, an upset in the natural balance of bacteria in the vagina of a woman, can cause problems for her baby during pregnancy.
Professor Adewale Sule-Odu, the principal investigator of this Tertiary Education Trust Fund-supported study, stated that the vagina contains mostly “good” bacteria and some harmful bacteria.
He declared that bacteria vaginosis occurs when the harmful bacteria grow in numbers, adding that a vagina should contain bacteria called lactobacilli that produce lactic acid to make the vagina slightly acidic and prevents other bacteria from growing there.
Professor Sule-Odu said activities such as frequent douching and the use of cotton wool or tissue paper to clean up after sex can predispose women to bacterial vaginosis, adding that in some cases, it comes with abnormal vaginal discharge, itching or odour.
He declared, “it can portend some adversity for the baby.”
The study had recruited 408 pregnant women in their third trimester receiving antenatal care at the hospital between June 2017 and May 2018.
They reported preterm delivery and birth asphyxia in 10.3 per cent and 29.6 per cent respectively in women with abnormal vaginal flora but no stillbirth babies.
The researchers compared the colour, homogeneity and consistency of vaginal secretions of these pregnant women at the onset of the study with when they go into labour.
These were pregnant women who had no history of bleeding through the vagina, drainage of amniotic fluid, medical complications of pregnancy or who did not take antibiotics in the preceding two weeks of the study commenced.
They treated pregnant women found with abnormal vagina flora with appropriate antibiotics, alongside their husbands to prevent reinfection.
After treatment, the percentage of pregnant women with abnormal vagina flora at labour reduced from 33 per cent to 14.4 per cent. The proportion of pregnant women with normal vagina flora during the antenatal period rose from 5.5 per cent to 23.9 per cent.
The researchers submitted that the prevalence of bacterial vaginosis is high in Nigerian pregnant women and its treatment in them is important for good foetal outcome
They, therefore, asked that antenatal screening for bacterial vaginosis should be included in the routine antenatal care investigations.
Dr Bayo Akadri said the study also found vaginal candidiasis, an organism that in pregnancy is associated with problems like prelabour rupture of amniotic membrane, preterm labour, preterm births and low birth weight babies in 38 per cent of the pregnant women studied.
According to him, vaginal candidiasis, which is commoner in pregnancy than non-pregnant women, is usually discomforting to pregnant women.
Dr Akadri declared, “This study also showed that women who were colonised with C.albicans had poorer foetal outcomes than those with non-albicans candida species.
“Vaginal Candida infection is common in pregnancy and appears to be associated with increased risk of adverse foetal outcomes. Screening for Candida vaginitis should be incorporated in routine antenatal care for early diagnosis and prompt treatment.”
Chief Medical Director OOUTH, Sagamu, Dr Oladipupo Adefuye, said that the conduit of delivery is mainly the vagina and when unclean, babies could be born with complications.
He declared: “That is why in some babies that are born, you see pus in their eyes and they may later go blind. There are other organisms that the baby can contact that can make it difficult for the baby to breathe even a few minutes or hours. So in essence, the vagina has to be clean.”
Vice chancellor, OOU, Ago Iwoye, Professor Ganiyu Olatunji Olatunde, represented by, deputy vice chancellor, administration, Professor Ebunoluwa Oduwole, stated that ”Here is an example of good work. For the university, it is a giant stride to showcase its transparency and accountability when it comes to grants.”