Hormonal contraception is associated with a reduced risk of bacterial vaginosis: a systematic review and meta-analysis.
<h4>Objective</h4>To examine the association between hormonal contraception (HC) and bacterial vaginosis (BV) by systematic review and meta-analysis.<h4>Methods</h4>Medline, Web of Science and Embase databases were searched to 24/1/13 and duplicate references removed. Inclusi...
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| Format: | Article |
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Public Library of Science (PLoS)
2013-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0073055 |
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| author | Lenka A Vodstrcil Jane S Hocking Matthew Law Sandra Walker Sepehr N Tabrizi Christopher K Fairley Catriona S Bradshaw |
| author_facet | Lenka A Vodstrcil Jane S Hocking Matthew Law Sandra Walker Sepehr N Tabrizi Christopher K Fairley Catriona S Bradshaw |
| author_sort | Lenka A Vodstrcil |
| collection | DOAJ |
| description | <h4>Objective</h4>To examine the association between hormonal contraception (HC) and bacterial vaginosis (BV) by systematic review and meta-analysis.<h4>Methods</h4>Medline, Web of Science and Embase databases were searched to 24/1/13 and duplicate references removed. Inclusion criteria 1) >20 BV cases; 2) accepted BV diagnostic method; 3) measure of HC-use either as combined oestrogen-progesterone HC (combined), progesterone-only contraception (POC) or unspecified HC (u-HC); 4) ≥ 10% of women using HC; 5) analysis of the association between BV and HC-use presented; 6) appropriate control group. Data extracted included: type of HC, BV diagnostic method and outcome (prevalent, incident, recurrent), and geographical and clinic-setting. Meta-analyses were conducted to calculate pooled effect sizes (ES), stratified by HC-type and BV outcome. This systematic review is registered with PROSPERO (CRD42013003699).<h4>Results</h4>Of 1713 unique references identified, 502 full-text articles were assessed for eligibility and 55 studies met inclusion criteria. Hormonal contraceptive use was associated with a significant reduction in the odds of prevalent BV (pooled effect size by random-effects [reES] = 0.68, 95%CI0.63-0.73), and in the relative risk (RR) of incident (reES = 0.82, 95%CI:0.72-0.92), and recurrent (reES = 0.69, 95%CI:0.59-0.91) BV. When stratified by HC-type, combined-HC and POC were both associated with decreased prevalence of BV and risk of incident BV. In the pooled analysis of the effect of HC-use on the composite outcome of prevalent/incident/recurrent BV, HC-use was associated with a reduced risk of any BV (reES = 0.78, 95%CI:0.74-0.82).<h4>Conclusion</h4>HC-use was associated with a significantly reduced risk of BV. This negative association was robust and present regardless of HC-type and evident across all three BV outcome measures. When stratified by HC-type, combined-HC and POC were both individually associated with a reduction in the prevalence and incidence of BV. This meta-analysis provides compelling evidence that HC-use influences a woman's risk of BV, with important implications for clinicians and researchers in the field. |
| format | Article |
| id | doaj-art-85c7d0ccbfee41eab406a374d60fc63b |
| institution | DOAJ |
| issn | 1932-6203 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj-art-85c7d0ccbfee41eab406a374d60fc63b2025-08-20T03:17:51ZengPublic Library of Science (PLoS)PLoS ONE1932-62032013-01-0189e7305510.1371/journal.pone.0073055Hormonal contraception is associated with a reduced risk of bacterial vaginosis: a systematic review and meta-analysis.Lenka A VodstrcilJane S HockingMatthew LawSandra WalkerSepehr N TabriziChristopher K FairleyCatriona S Bradshaw<h4>Objective</h4>To examine the association between hormonal contraception (HC) and bacterial vaginosis (BV) by systematic review and meta-analysis.<h4>Methods</h4>Medline, Web of Science and Embase databases were searched to 24/1/13 and duplicate references removed. Inclusion criteria 1) >20 BV cases; 2) accepted BV diagnostic method; 3) measure of HC-use either as combined oestrogen-progesterone HC (combined), progesterone-only contraception (POC) or unspecified HC (u-HC); 4) ≥ 10% of women using HC; 5) analysis of the association between BV and HC-use presented; 6) appropriate control group. Data extracted included: type of HC, BV diagnostic method and outcome (prevalent, incident, recurrent), and geographical and clinic-setting. Meta-analyses were conducted to calculate pooled effect sizes (ES), stratified by HC-type and BV outcome. This systematic review is registered with PROSPERO (CRD42013003699).<h4>Results</h4>Of 1713 unique references identified, 502 full-text articles were assessed for eligibility and 55 studies met inclusion criteria. Hormonal contraceptive use was associated with a significant reduction in the odds of prevalent BV (pooled effect size by random-effects [reES] = 0.68, 95%CI0.63-0.73), and in the relative risk (RR) of incident (reES = 0.82, 95%CI:0.72-0.92), and recurrent (reES = 0.69, 95%CI:0.59-0.91) BV. When stratified by HC-type, combined-HC and POC were both associated with decreased prevalence of BV and risk of incident BV. In the pooled analysis of the effect of HC-use on the composite outcome of prevalent/incident/recurrent BV, HC-use was associated with a reduced risk of any BV (reES = 0.78, 95%CI:0.74-0.82).<h4>Conclusion</h4>HC-use was associated with a significantly reduced risk of BV. This negative association was robust and present regardless of HC-type and evident across all three BV outcome measures. When stratified by HC-type, combined-HC and POC were both individually associated with a reduction in the prevalence and incidence of BV. This meta-analysis provides compelling evidence that HC-use influences a woman's risk of BV, with important implications for clinicians and researchers in the field.https://doi.org/10.1371/journal.pone.0073055 |
| spellingShingle | Lenka A Vodstrcil Jane S Hocking Matthew Law Sandra Walker Sepehr N Tabrizi Christopher K Fairley Catriona S Bradshaw Hormonal contraception is associated with a reduced risk of bacterial vaginosis: a systematic review and meta-analysis. PLoS ONE |
| title | Hormonal contraception is associated with a reduced risk of bacterial vaginosis: a systematic review and meta-analysis. |
| title_full | Hormonal contraception is associated with a reduced risk of bacterial vaginosis: a systematic review and meta-analysis. |
| title_fullStr | Hormonal contraception is associated with a reduced risk of bacterial vaginosis: a systematic review and meta-analysis. |
| title_full_unstemmed | Hormonal contraception is associated with a reduced risk of bacterial vaginosis: a systematic review and meta-analysis. |
| title_short | Hormonal contraception is associated with a reduced risk of bacterial vaginosis: a systematic review and meta-analysis. |
| title_sort | hormonal contraception is associated with a reduced risk of bacterial vaginosis a systematic review and meta analysis |
| url | https://doi.org/10.1371/journal.pone.0073055 |
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