Risk factors of recurrent bacterial vaginosis among women of reproductive age: A cross-sectional study

Abstract Background: Bacterial vaginosis (BV) is the most common cause of vaginitis and is associated with an increased risk of health problems. Our study aims to explore risk factors of recurrent BV (RBV) among women of reproductive age and offer references for clinical prevention and treatment of BV.Methods: This cross-sectional study was carried out in Gynecology Outpatient Clinic of the First Affiliated Hospital of Xi’an Jiaotong University from June 2016 to June 2019 in real-world conditions. Women with RBV were selected，and simultaneously uncomplicated BV (UBV) patients and those who underwent routine gynecological examination and had normal vaginal microflora (NVM) were also recruited as the control. We conducted a face-to-face questionnaire survey and a multivariate logistic regression analysis to uncover the related risk factors of RBV and UBV.Results: Totally, 316 participants were enrolled in the present study, including 68 RBV patients, 135 UBV patients and 113 NVM women. Univariate analysis showed that unemployment, desserts and wiping were the risk factors for UBV (P2<0.05), while education, high BMI index, smoking and sedentary lifestyle were risk factors for both RBV and UBV (P1<0.05). In addition, history of HPV infection, contraceptive methods, age at FSI and not cleaning vulva during sexual actvity were the risk factors for UBV (P2<0.05), while history of other vaginitis and number of sexual partners in the previous year were risk factors for both RBV and UBV (P1<0.05). Multivariate Logistic regression analysis revealed that lower educational level increased the risk of suffering RBV (OR =2.842, 95% CI = 1.177-6.859, P =0.020). Interestingly, no smoking was a protective factor (OR =0.371, 95% CI = 0.152-0.885, P =0.026). Moreover, absence of other vaginitis and exclusive sexual partner could also weaken the risk of incurring RBV. However, there was no statistical difference between non-sedentary lifestyle, BMI and RBV.Conclusions: Risk factors of RBV are various, involving women's socioeconomic status, hygienic habits, disease history and other aspects. It is necessary to take corresponding measures to avoid risk factors and to help lessening the prevalence of RBV among women of reproductive age.This study was registered in the Thai Clinical Trials Registry (www.clinicaltrials.in.th) on 24 February 2018, and the registered number was, TCTR20180223002, retrospectively registered