Prevalence of bacterial vaginosis and assessment of Associated factors among pregnant women attending the Antenatal care clinic of jimma medical center, southwest Ethiopia

Abstract

Background: Bacterial vaginosis (BV) is a common vaginal dysbiosis characterized by a reduction in protective Lactobacillus species and an overgrowth of diverse facultative and anaerobic bacteria such as G. vaginalis. BV is a significant public health concern, particularly among pregnant women, as it is associated with adverse obstetric outcomes such as preterm birth and increased susceptibility to STIs. The epidemiology and contributing factors of BV demonstrate geographical variability, with higher prevalence rates reported in sub-Saharan Africa. Despite its prevalence, limited data exist on BV and its associated factors among pregnant women in southwest Ethiopia. Objective: The purpose of this study was to determine the prevalence of bacterial vaginosis and assess associated factors among pregnant women attending the antenatal care clinic of Jimma Medical Center from January 1 to March 30, 2025, Jimma town, Southwest Ethiopia. Methods: A cross-sectional study was conducted at Jimma Medical Center from January to March 2025, involving 285 pregnant women attending antenatal care. Systematic random sampling was used to recruit participants. Data were collected through structured interviews and laboratory analysis of vaginal swabs. Diagnosis of BV was based on Amsel‘s clinical criteria and Nugent scoring from Gram-stained smears. Culture technique was used to explore microbiological profile. Data were entered into EpiData 3.1 and analyzed using SPSS version 25. Descriptive statistics were used to summarize the data, and Multivariate logistic regression analysis was conducted to identify variables independently associated with BV. P value <0.05 was considered statistically significant. Results: The overall prevalence of BV was 22.5% (64 out of 285). Significant independent predictors of BV included: history of STIs (AOR=6.279, CI: 1.844, 21.381), vaginal discharge (AOR=3.143, CI: 1.106, 8.937), lower abdominal pain (AOR=4.055, CI: 1.372, 11.985), spontaneous abortion (AOR = 7.995, CI: 2.139, 29.882), preterm labor or birth (AOR=10.043, CI: 3.009, 33.522), vaginal douching (AOR=5.6, CI: 2.01, 15.5), and having multiple sexual partners (AOR=8.468, CI: 2.390, 30.008). G. vaginalis was the most frequently isolated organism. Conclusion: Bacterial vaginosis is common among pregnant women in this setting and is significantly associated with clinical symptoms and behavioral factors. Its link to adverse pregnancy outcomes emphasizes the need for early detection and management. Recommendation: Routine screening for BV should be integrated into antenatal care services, particularly for women with a history of STIs or obstetric complications. Health education programs should address harmful vaginal hygiene practices and promote safe sexual behaviors. Further longitudinal studies are recommended to explore causality and evaluate treatment outcomes.