Longitudinal Study Of Vaginal Flora

细菌性阴道病是一种综合征，其中正常的乳酸菌为主的阴道菌群被混合厌氧菌为主的微生物所取代。在一般人群中，10%至25%的妇女患有此病，是最常见的阴道感染。它与生殖健康方面的许多不良后遗症有关，包括艾滋病毒感染、盆腔炎、宫颈发育不良和妇科手术并发症。在怀孕期间，它与早产和产后母体感染的风险增加有关。然而，阴道微生物菌群仍然知之甚少。关于微生物菌群的变化及其与细菌性胃炎的关系的纵向研究的信息是不可用的。这项前瞻性观察性研究旨在提高我们对阴道微生物菌群的自然史和异常变化的认识，并确定与这些变化相关的危险因素。在阿拉巴马州伯明翰，共有5500名健康、未怀孕的育龄妇女将被登记并随访一年（基线检查加上此后每三个月一次，共计5次检查）。将通过面对面访谈收集有关社会人口状况、病史、卫生习惯、性行为和心理社会压力的详细信息。在研究访问期间将进行常规妇科和牙科检查。将采集阴道分泌物和血液样本。将进行实验室测试，以确定阴道微生物菌群的数量，并确定细菌性阴道病的感染以及常见的性传播疾病。次级研究将评估阴道菌群的日常变化，以及停止冲洗的效果。

Bacterial vaginosis is a syndrome in which the normal Lactobacillus-predominant vaginal flora is replaced with mixed anaerobic-predominant organisms. It is present in 10 to 25% of women in the general population, and is the most common vaginal infection. It has been associated with a number of adverse sequelae in reproductive health including acquisition of HIV, pelvic inflammatory disease, cervical dysplasia, and complications of gynecological procedures. During pregnancy it has been associated with an increased risk of preterm birth and postpartum maternal infection. However, the vaginal microbial flora remains poorly understood. Information on variation in microbial flora and its association with BV from a longitudinal study is unavailable. This prospective observational study aims to advance our knowledge of the natural history and abnormal alteration in vaginal microbial flora, and to identify risk factors that are associated with these changes. A total of 5500 healthy, non-pregnant women of reproductive age will be enrolled and followed in Birmingham, Alabama for one year (baseline visit plus once every three months afterwards, totaling five visits). Detailed information on sociodemographic status, medical history, hygiene practice, sexual behavior and psychosocial stress will be collected through in-person interviews. Routine gynecological and dental examinations will be carried out during the study visits. Samples of vaginal secretion and blood will be collected. Laboratory tests to quantify vaginal microbial flora and to identify infection of bacterial vaginosis as well as common sexually transmitted diseases will be conducted. Sub-studies will evaluate the day-to-day change in vaginal flora, and the effect of cessation of douching.