BACTERIAL-COLONIZATION OF THE VAGINA DURING PREGNANCY IN 4 ETHNIC-GROUPS

OBJECTIVE: Our purpose was determine whether there are ethnic diferenc es in vaginal colonization with organisms reputed to be associated wit h preterm delivery. STUDY DESIGN: In seven urban medical centers in th e United States from 1984 to 1989, 13,747 predominantly low-socioecono mic-status women at 23 to 26 weeks' gestation were grouped according t o ethnic origin. Each had a vaginal culture for multiple organisms and Gram's stain and pH test to diagnose bacterial vaginosis. Multivariat e analyses with adjustment for maternal age, insurance status, marital status, smoking history, education level, age at first sexual interco urse, and number of male partners in the past year were also performed to determine the odds ratio for a black woman versus a white woman ha ving a positive test result. RESULTS: For nearly every organism studie d, Asian-Pacific Islander and white women had the lowest percentages o f positive test results whereas black women had the highest. When blac k and white women are compared, black women were more likely to be col onized with Chlamydia trachomatis, 16% versus 5%; Neisseria gonorrhoea e, 2.5% versus 0.4%; Bacteroides sp., 25% versus 14%; bacterial vagino sis, 23% versus 9%; and the four other organisms evaluated. Adjustment for potential confounders including certain health behaviors did not markedly change the risk of a black woman having a positive test resul t, with the odds ratios for colonization with each organism ranging fr om 1.8 to 6.4. CONCLUSIONS: Highly significant differences exist in va ginal colonization patterns among women of different ethnic groups, wi th the highest rates of potentially pathogenic organisms observed in b lack women and the lowest in Asian-Pacific Islander women. Differences in health behaviors do not explain the Variation in colonization rate s.