Vitamin D Deficiency Linked to Bacterial Vaginosis in Pregnant Women

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Vitamin D deficiency (VDD) has been linked to bacterial vaginosis (BV) among

pregnant women, according to the results of a study reported online October

4 in the *American Journal of Obstetrics & Gynecology.*

" Recent data suggest ...VDD is associated with ...BV during pregnancy, "

write J. Hensel, MPH, from the College of Physicians and Surgeons

at Columbia University in New York, NY, and colleagues. " We hypothesized

that VDD is a risk factor for BV in nonpregnant women. "

The investigators conducted multivariable logistic regression analyses

stratified by pregnancy, using data from the National Health and Nutrition

Examination Survey.

In pregnant women, but not in nonpregnant women, VDD was associated with an

increased risk for BV (adjusted odds ratio [AOR], 2.87; 95% confidence

interval [CI], 1.13 - 7.28).

Factors associated with BV in nonpregnant women were douching (AOR, 1.72;

95% CI, 1.25 - 2.37), smoking (AOR, 1.66; 95% CI, 1.23 - 2.24), and black

race (AOR, 2.41; 95% CI, 1.67 - 3.47). Use of oral contraceptives was

inversely associated with BV (AOR, 0.60; 95% CI, 0.40 - 0.90). In

nonpregnant women, VDD modulated the association between smoking and BV.

" Risk factors for BV differ by pregnancy status, " the study authors write.

" VDD was a modifiable risk factor for BV among pregnant women; evaluation of

vitamin D supplementation for prevention or adjunct therapy of BV in

pregnancy is warranted. "

Limitations of this study include cross-sectional design, sexual behavior

data limited to women 20 years or older, and information on unprotected sex

asked only of women reporting multiple sexual partners in 1 year. In

addition, changes in laboratory methods with time may result in variability

in the vitamin D assay, and this analysis did not examine the association

between VDD and BV by trimester of pregnancy.

" Because antimicrobial treatment for BV has failed to reduce some adverse

sequelae of this disease in pregnancy, BV prevention is paramount, " the

study authors conclude. " dentification of VDD as a modifiable risk factor

for BV among pregnant women may be important in improving health outcomes

among this population....In addition, optimization of strategies for the use

of prenatal vitamins, including preconceptual use, may aid in the prevention

of BV during pregnancy. "

*Senior author Adam J. Ratner, MD, MPH, is supported by the Doris Duke

Charitable Foundation, Flight Attendant Medical Research Institute, M.

Driscoll Children's Fund Scholar Award (Columbia University), Louis V.

Gerstner Jr Scholar Award (Columbia University), and Irving Scholars Award

(Columbia University).*

*Am J Obstet Gynecol.* Published online October 4, 2010.

--

Ortiz, MS, RD

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