Vaginal bacterial and fungal flora in pregnant diabetic and non-diabetic women: a multi center observational case-control study

Objective: We evaluated the prevalence of cervicovaginal Bacteria, group B Streptococcus (GBS), Gardnerella vaginalis (GV), Candida spp., Chlamydia trachomatis (CT), Mycoplasma hominis (MH) and Ureaplasma urealyticum (UU) in pregnant women with and without diabetes mellitus (DM). Materials and method: Cervicovaginal swabs were gathered from 473 pregnant patients divided into 127 diabetic and 346 non-diabetic. The results were correlated to gestational age, parity and glycemic control. Results: A higher prevalence of MH/UU (P=0.012) was found in the diabetic patients. After the 28th weeks of pregnancy the prevalence for all investigated microorganisms appeared similar except for MH/UU (P=0.014). In multigravida were there statistically differences between two groups in testing for Bacteria (P=0.015) and for MH/UU (P=0.037). The diabetic condition correlated to the state of multigravida in cases positive for Candida spp (P=0.049) and in those testing positive for at least one microorganism (P=0.043). Pregnant with a blood glucose > 92 have twice the risk of being positive to a single microbiological test than those with better glycemic control. Conclusions: The higher prevalence of MH/UU after the 28 th weeks can be explained with the physiological reduced insulin tolerance characteristic of this gestational period. Among the diabetic testing positive to Candida spp the statistically significant association was observed only in multigravida condition. These data suggest that diabetic multigravida are at increased risk for Candida spp infection in relation to the improper glycemic control.