Longitudinal Study Of Vaginal Flora

细菌性阴道病是一种以乳杆菌为主的正常阴道菌群被以厌氧菌为主的混合微生物取代的综合征。在普通人群中，有10%到25%的女性患有此病，是最常见的阴道感染。它与生殖健康中的一些不良后遗症有关，包括感染艾滋病毒、盆腔炎、宫颈发育不良和妇科手术的并发症。在怀孕期间，它与早产和产后产妇感染的风险增加有关。然而，阴道微生物区系仍然知之甚少。关于微生物区系的变化及其与BV的关系的纵向研究的信息是不可用的。这项前瞻性的观察性研究旨在提高我们对阴道微生物区系的自然历史和异常变化的认识，并确定与这些变化相关的危险因素。共有5500名健康的、未怀孕的育龄妇女将在阿拉巴马州的伯明翰接受为期一年的跟踪调查(基线访问加上之后每三个月一次，总共五次访问)。将通过面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。在考察期间，将进行常规的妇科和牙科检查。将采集阴道分泌物和血液样本。将进行实验室测试，以量化阴道微生物菌群，并确定细菌性阴道病和常见性传播疾病的感染情况。子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.