ArticleThe Journal of infectious diseases2021
Bacterial Vaginosis and Behavioral Factors Associated With Incident Pelvic Inflammatory Disease in the Longitudinal Study of Vaginal Flora.
Article in The Journal of infectious diseases, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers.
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Who cites it
30 citing papers in PubMed, 36 citations in OpenAlex.
- Association Between Vaginal Microbiota and Female Infertility: A Systematic Review and Meta-Analysis.Microorganisms · 2026Review
- Inverse Association Between Composite Dietary Antioxidant Index and Prevalence of Pelvic Inflammatory Disease Among Women: A Cross-Sectional Study of NHANES 2013-2018.Healthcare (Basel, Switzerland) · 2026Article
- Genomic Diversity of VaginalViruses · 2026Article
- The Role of the Vaginal Microbiome in Gynecological Diseases: Mechanistic Insights and Emerging Interventions.Biology · 2026Review
- A qualitative exploration of menstrual management practices and the impact of menstruation on the livelihoods of female sex workers in a peri-urban area of western Kenya.Frontiers in reproductive health · 2026Article
- The hormone-microbiota-NET framework in gynecologic diseases: evidence, controversies, and translational opportunities.Frontiers in immunology · 2026Review
- Nutrition in the prevention and treatment of pelvic inflammatory disease: a review.Frontiers in nutrition · 2026Review
- Gut-reproduction axis: a new perspective on understanding pelvic inflammatory disease.Frontiers in microbiology · 2026Review
- Vaginal microbiome knowledge and hygiene practices among women in Saudi Arabia: a cross-sectional study.BMC public health · 2025Article
- Prevalence and associated risk factors of bacterial vaginosis among women of reproductive age living with, and without HIV in Lagos, Nigeria.BMC women's health · 2025Article
- Bacterial vaginosis toxins impair sperm capacitation and fertilization.Human reproduction (Oxford, England) · 2025Article
- The association between dietary fiber intake and pelvic inflammatory disease in women: findings from the NHANES 2015-2018.BMC women's health · 2025Article
- Bacterial vaginosis.Nature reviews. Disease primers · 2025Review
- Social, microbial, and immune factors linking bacterial vaginosis and infectious diseases.The Journal of clinical investigation · 2025Review
- Article
- Trends in infections detected in women with cervicitis over a decade.Frontiers in reproductive health · 2025Article
- Dietary habits and vaginal environment: can a beneficial impact be expected?Frontiers in cellular and infection microbiology · 2025Article
- Therapeutic potential of botanical drugs and their metabolites in the treatment of pelvic inflammatory disease.Frontiers in pharmacology · 2025Review
- Choline Intake and Pelvic Inflammatory Disease Risk: A Cross-Sectional Study Based on NHANES 2013-2018.International journal of women's health · 2025Article
- The importance of understanding pelvic inflammatory disease as a polymicrobial infection.The Lancet regional health. Europe · 2024Article
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Authors and funding
6 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundPelvic inflammatory disease (PID) leads to long-term reproductive consequences for cisgender women. Bacterial vaginosis (BV) and behavioral factors may play a role in PID pathogenesis. We assessed associations between BV, behavioral factors, and incident PID.
methodsWe analyzed participants (N = 2956) enrolled in the National Institutes of Health Longitudinal Study of Vaginal Flora, a cohort of nonpregnant cisgender women followed quarterly for 12 months. PID was defined by at least 1 of the following: cervical motion tenderness, uterine tenderness, or adnexal tenderness (160 cases). We tested associations between BV (measured using Nugent and Amsel criteria) and PID at the subsequent visit. Sociodemographic factors, sexual behaviors, and Chlamydia trachomatis (CT), untreated at baseline and concurrent with BV, were covariates in Cox proportional hazards models. Adjusting for the few Neisseria gonorrhoeae and Trichomonas vaginalis cases did not alter results.
resultsIn multivariable modeling, Nugent-BV (adjusted hazard ratio [aHR], 1.53 [95% confidence interval {CI}, 1.05-2.21]), symptomatic Amsel-BV (aHR, 2.15 [95% CI, 1.23-3.75]), and vaginal douching (aHR, 1.47 [95% CI, 1.03-2.09]) were associated with incident PID.
conclusionsBV was associated with incident PID in a large prospective cohort, controlling for behavioral factors and sexually transmitted infections (STIs). Larger studies on how BV, STIs, behaviors, and host responses interactively affect PID risk are needed.
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