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Psychological and biological markers of stress and bacterial vaginosis in pregnant women

  1. EW Harville1,†,*,
  2. DA Savitz1,‡,
  3. N Dole2,
  4. JM Thorp Jr3,
  5. AH Herring2,4

Article first published online: 9 JAN 2007

DOI: 10.1111/j.1471-0528.2006.01209.x

Issue

BJOG: An International Journal of Obstetrics & Gynaecology

BJOG: An International Journal of Obstetrics & Gynaecology

Volume 114, Issue 2, pages 216–223, February 2007

Additional Information

How to Cite

Harville, E., Savitz, D., Dole, N., Thorp, J. and Herring, A. (2007), Psychological and biological markers of stress and bacterial vaginosis in pregnant women. BJOG: An International Journal of Obstetrics & Gynaecology, 114: 216–223. doi: 10.1111/j.1471-0528.2006.01209.x

Author Information

  1. 1

    Department of Epidemiology

  2. 2

    Carolina Population Center

  3. 3

    Department of Obstetrics & Gynecology

  4. 4

    Department of Biostatistics, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA

  1. †

    Currently at Department of Epidemiology, Tulane University School of Public Health & Tropical Medicine, New Orleans, LA, USA.

  2. ‡

    Currently at the Department of Community and Preventive Medicine, Mount Sinai School of Medicine, New York, NY, USA.

*Dr EW Harville, Department of Epidemiology, Tulane University School of Public Health & Tropical Medicine, 1440 Canal Street SL-18, Room 2012, New Orleans, LA 70112, USA. Email Harville@tulane.edu

Publication History

  1. Issue published online: 9 JAN 2007
  2. Article first published online: 9 JAN 2007
  3. Accepted 31 October 2006.

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Keywords:

  • Bacterial vaginosis;
  • hormones;
  • pregnancy;
  • psychological stress

Objectives  To determine whether stress is associated with risk of bacterial vaginosis (BV) in pregnant women.

Design  Prospective cohort study.

Setting  The prenatal care clinics at the University of North Carolina. The residents’ clinic sees mostly government-insured and uninsured women, and the physicians’ clinic sees mostly those with private health insurance.

Population  A total of 897 women gave samples for BV analysis. Study participants were 22% African-American, 68% white; 24% unmarried and 44% nulliparous. More than half had completed college.

Methods  Women completed two questionnaires and two interviews reporting stress and psychological aspects of their lives. Measurement scales included the Sarason life events questionnaire, the Cohen perceived stress scale, Spielberger state–trait anxiety, the John Henryism coping style and the Medical Outcomes Study social support inventory. Two stress hormones, corticotrophin-releasing hormone and cortisol, were also measured.

Main outcome measures  BV at 15–19 and 24–29 weeks of gestation was diagnosed by Gram’s stain.

Results  Women in the highest quartile of stress measures, particularly state anxiety (OR = 2.0, 95% CI 1.2–3.3), perceived stress (OR = 2.4, 95% CI 1.5–3.9) and total life events (OR = 2.0, 95% CI 1.3–3.2), had the highest risk of BV. Adjustment for confounders, especially age, race, and income, reduced these associations (state anxiety: OR = 1.3, 95% CI 0.7–2.4; perceived stress: OR = 1.4, 95% CI 0.8–2.5; total life events: OR = 1.3, 95% CI 0.7–2.4). No clear pattern of association was seen between stress hormones and BV.

Conclusions  Few associations between stress and BV were seen after adjustment for confounders.

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