Vaginal Candida infection in pregnancy and its implications for fetal well-being

Adewale O Sule-Odu, Adebayo A Akadri, Adedayo A Oluwole, Olubunmi A Osinupebi, Babatunde A Andu, Adeniyi K Akiseku, Akinlade I Lawal

Abstract

Vaginal Candida infection is one of the most common genital tract infections reported in pregnant women. This study was designed to determine the prevalence of vaginal Candida infection and pattern of Candida species isolates in the genital tract of pregnant women during antenatal period and in early labour; and the associated fetal outcome. The study was conducted at the antenatal clinic and labor ward of Olabisi Onabanjo University Teaching Hospital Sagamu, Ogun State, Nigeria. High vaginal swabs were collected from 408 pregnant women at the antenatal clinic and repeated in early labour. The samples were processed to isolate Candida species. Data were analysed using Statistical Package for Social Science (SPSS) windows version 21.0 (IBM Corp., Armonk, NY, USA). Prevalence of Candida infection was significantly higher in early labour (46%) than during antenatal period (38%) (P=0.02). Candida albicans was the predominant isolate, followed by Candida glabrata and Candida tropicalis. Candida infection was associated with increased likelihood of low birth weight babies (AOR 2.8, CI: 1.1-6.8; P= 0.03). However there was no statistically significant effect of Candida infection on the likelihood of preterm delivery (AOR 1.4, CI: 0.7-2.6; P= 0.35). Routine screening and prompt treatment of women at risk of delivering low birth weight babies is advocated. (Afr J Reprod Health 2020; 24[3]: 33-40).

Full Text:

PDF

References

Cribby S, Taylor M and Reid G. Vaginal microbiota and

the use of probiotics. Interdiscip Perspect Infect Dis. 2008; 2008:256490. doi: 10.1155/2008/256490. Epub 2009 Mar 29

Rathod S and Vijayalakshmi S. Prevalence of vaginitis

during pregnancy and its fetomaternal outcome in the rural setup. Int J Reprod Contracept Obstet Gynecol. 2016;5(6):1823-1826

Nuriel-Ohayon M, Neuman H and Koren O. Microbial

changes during pregnancy, birth, and infancy. Front Microbiol. 2016; 7:1031. doi: 10.3389/fmicb.2016.01031

Sule-Odu AO, Akadri AA, Adeiyi TO, Sotunsa JO,

Durojaiye BO and Oluwole AA. Asymptomatic genital infection among pregnant women in Sagamu, Nigeria. Trop J Obstet Gynaecol. 2015; 32(1): 7-13.

Akerele J, Abhulimen P and Okonofua F. Prevalence of

asymptomatic genital infection among pregnant women in Benin City, Nigeria. Afr J Reprod Health 2002; 6(3): 93-97.

Leli C, Menaccit A and Meucci M. Association of

pregnancy and Candida vaginal colonization in women with or without symptoms of vulvovaginitis. Minerva Ginecol. 2013;65(3):303–309.

Nnadi DC and Singh S. The prevalence of genital

Candida species among pregnant women attending antenatal clinic in a tertiary health center in North-west Nigeria. Sahel Med J. 2017;20:33-7.

Oviasogie FE and Okungbowa FI. Candida species

amongst pregnant women in Benin City, Nigeria: Effect of predisposing factors. Afr J Clin Exper Microbiol 2009; 10(2): 92-98

Altayyar IA, Alsanosi AS and Osman NA. Prevalence of

vaginal candidiasis among pregnant women attending different gynecological clinic at South Libya. Eur J Exp Bio. 2016, 6(3):25-29

Adib SM, Bared EEL, Fanous R and Kyiacos S. Practices

of Lebanese gynaecologist regarding treatment of recurrent vulvovaginal Candidiasis. North Am J Med Sci. 2011;3:406-10.

Farr A, Kiss H, Holzer I, Husslein P, Hagmann M and

Petricevic L. Effect of asymptomatic vaginal colonization with Candida albicans on pregnancy outcome. Acta Obstet Gynecol Scand. 2015;94(9):989–996. doi: 10.1111/aogs.12697

Maki Y, Fujisaki M, Sato Y and Sameshima H. Candida

chorioamnionitis leads to preterm birth and adverse fetal-Neonatal outcome. Infect Dis Obstet Gynecol. 2017; 2017:9060138. doi:10. 1155/2017/9060138

Roberts CL, Algert CS, Richard KL and Morris JM.

Treatment of vaginal candidiasis for prevention of preterm birth: a systematic review and meta-analysis. Syst Rev. 2015;4:31. doi: 10.1186/s13643-015-0018-2.

Akinbami NA, Babalola GO, Shittu MO, Tijani AM and

Adekola SA. Detection and Epidemiology of Vulvovaginal Candidiasis among Asymptomatic Pregnant Women Attending a Tertiary Hospital in Ogbomoso, Nigeria. Intl J Biomed Res. 2015; 6(07): 518-523.

National Committee for Clinical Laboratory Standards.

Reference method for broth dilution antifungal susceptibility testing of yeasts; approved standard-Second Edition. NCCLS document M27-A2 [ISBN 1-56238-469-4]. NCCLS, 940 West Valley Road, Suite 1400, Wayne, Pennsylvania 19087-1898 USA, 2002

Oyeyipo OO and Onasoga MF. Incidence and Speciation

of Candida Species among Non-gravid young Females in Ilorin, North Central, Nigeria. J Appl Sci Environ Manage 2015; 19 (4) 680 - 685

Ibrahim SM, Bukar M, Mohammed Y, Audu BM and

Ibrahim HM. Prevalence of vaginal candidiasis among pregnant women with abnormal vaginal discharge in Maiduguri. Niger J Med 2013; 22(2): 138-142

Sangare I, Sirima C, Bamba S, ZidaA, Cissé M, Bazié

WW, Sanou S, Dao B, Menan H and Guiguemdé RT. Prevalence of vulvovaginal candidiasis in pregnancy at three health centers in Burkina Faso. J Mycol Med 2018; 28(1): 186-192

Mucci MJ, Cuestas ML, Landanburu MF andMujica MT.

Prevalence of Candida albicans, Candida dubliniensisand Candida Africana in pregnant women suffering from vulvovaginal candidiasis in Argentina. Rev Iberoam Micol 2017; 34(2): 72-76

Okonkwo NJ and Umeanaeto PU. Prevalence of vaginal

candidiasis among pregnant women in Nnewi town of Anambra state. Afr Rsch Rev. 2010;4:539-48.

Aguin TJ and Sobel JD. Vulvovaginal candidiasis in

pregnancy. Curr Infect Dis Rep. 2015; 17(6):462. doi: 10.1007/s11908-015-0462-0.

Pirotta MV, Gunn JM and Chondros P. “Not thrush

again!” Women’s experience of post‑antibiotic vulvovaginitis. Med J Aust. 2003;179:43‑6.

Scorzoni L, de Lucas MP, Mesa-Arango AC, Fusco-

Almeida AM, Lozano E, Cuenca-Estrella M, Mendes-Giannini MJ and Zaragoza O. Antifungal efficacy during Candida Krusei infection in non-conventional models correlates with the yeast in vitro susceptibility profile. PLoS One 2013; 8(3): e60047. doi: 10: 1371/journal.pone.0060047

Mølgaard-Nielsen D, Pasternak B and Hviid A. Use of

oral fluconazole during pregnancy and the risk of birth defects. N Engl J Med 2013;369(9): 830-9. doi: 10. 1056/NEJMoa 1301066

Kaplan YC, Koren G and Bozzo P. Fluconazole exposure

during pregnancy. Can Fam Physician

;61(8):685-6.

Richter SS, Galask RP, Messer SA, Hollis RJ, Diekema

DJ and Pfaller MA. Antifungal Susceptibilities of Candida Species Causing Vulvovaginitis and Epidemiology of Recurrent Cases. J Clin Microbiol 2005; 43(5): 2155-62

Gupta S, Tripathi R, Singh N, Bhalla P, Ramji S and

Mala YM. Pregnancy outcome in asymptomatic women with abnormal vaginal flora without any treatment and after treatment with vaginal clindamycin and clotrimazole: A randomised controlled trial. S Afr J OG 2013;19(2):35-38. DOI:10.7196/SAJOG.626.

Rasti S, Asadi MA, Taghriri A, Behrashi M and

Mousavie G. Vaginal candidiasis complications on pregnant women. Jundishapur J Microbiol 2014;7(2):e10078. doi: 10.5812/jjm.10078.

Kaufman DA, Gurka MJ, Hazen KC, Boyle R, Robinson

M and Grossman LB. Pattern of fungal colonization in preterm infants weighing less than 1000 grams at birth. Pediatr Infect Dis J 2006; 25(8): 733-7.

Refbacks

  • There are currently no refbacks.