Published in PLOS One on 2026-07-31, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Dennis Gyasi Konadu, Alex Kwame Owusu-Ofori, David Kwame Dosoo, Zuwera Yidana, Gladys Matuamo Ngo, Philomina Nkansah Nfum, Richard Joshua Tetteh, Dennis Adu-Gyasi, Kwaku Poku-Asante
Source: PLOS One • DOI 10.1371/journal.pone.0354974
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
Bacterial vaginosis (BV) is highly prevalent in women of African origin and has been associated with adverse birth outcomes (ABO), particularly preterm birth (PTB). However, evidence from sub-Saharan Africa remains limited, and while a previous study conducted in this area examined the prevalence of BV, its impact on pregnancy outcomes was not assessed. This study assessed the prevalence and risk factors of BV in early pregnancy and examined its association with ABO in the middle belt of Ghana.
This analysis was nested within a prospective cohort of pregnant women in the Kintampo North Municipality and Kintampo South District. Pregnant women <20 weeks’ gestational age were screened, consented, enrolled and followed through delivery until one year after birth. At enrolment, sociodemographic, behavioural, and obstetric data were collected, along with biological samples, including vaginal swabs for Gram staining and Nugent scoring. BV status was categorized as BV-negative (0–6) or BV-positive (7–10) and ABO included PTB (<37 weeks), low birthweight (LBW < 2.5 kg), and foetal loss. Data were double-entered in REDCap and analysed in R. Associations between BV and ABO were assessed using chi-square tests, and logistic regression was used to identify risk factors for BV.
Of 1,180 pregnant women enrolled, 355 (30.1%) were BV-positive. PTB (9.9% vs. 8.7%; p = 0.50), LBW (13.8% vs. 12.0%; p = 0.39), and foetal loss (4.5% vs. 2.8%; p = 0.14) were all higher among BV-positive women, but none reached statistical significance. Younger age and unmarried status were associated with BV. Unmarried women (AOR 1.63; 95% CI: 1.20–2.22) and those reporting one sexual encounter per week (AOR 1.55; 95% CI: 1.01–2.37) had increased odds of BV.
BV is highly prevalent in early pregnancy in this Ghanaian cohort, particularly among younger and unmarried women, but was not significantly associated with ABO. Targeted screening among high-risk groups is necessary, and future molecular approaches may better characterise BV subtypes linked to ABO in African settings.
Introduction
Bacterial vaginosis (BV), an endogenous infection, is a dysbiosis of the vaginal microbiota characterized by a decrease in Lactobacillus spp. and an overgrowth of anaerobic bacteria such as Gardnerella spp, Prevotella spp, and Mobiluncus spp., [1]. This dysbiosis has significant implications in pregnancy given its association with adverse maternal and foetal outcomes [2,3]. In sub-Saharan Africa, the burden of BV among pregnant women remains substantial [4–6], coinciding with elevated rates of preterm birth (PTB), low birth weight (LBW), and perinatal morbidity and mortality [7].
BV is prevalent in women of African origin with rates such as 26.3% [5] in Democratic Republic of Congo, 30.9% in Ghana [6] and as high as 48.5% in Uganda [8]. A systematic review by Park et al (2024), reported that women of sub-Saharan Africa had the highest pooled prevalence of 25.1%, followed by 22.6% in Latin America and the Caribbean [4]. These rates indicate a high burden of BV in people of African origin and the need to develop measures to mitigate its effect in pregnancy.
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider research & evidence desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Dennis Gyasi Konadu, Alex Kwame Owusu-Ofori, David Kwame Dosoo, Zuwera Yidana, Gladys Matuamo Ngo, Philomina Nkansah Nfum, Richard Joshua Tetteh, Dennis Adu-Gyasi, Kwaku Poku-Asante. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
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