Diabetes in Pregnancy: High Risk for Vulvovaginal Candidiasis

Abstract

Background: Vulvo-vaginal candidiasis [VVC] is the most common cause of vaginitis and the incidence of candidiasis almost doubles in pregnant women, particularly in the third trimester. Pregnancy can be affected by VVC in a very negative manner as it can lead to candida chorioamnionitis and subsequent preterm delivery. Premature neonates are severely endangered by generalized fungal infections, therefore prevention of fungal infections is of utmost importance. Objectives: The objective of our study was estimation of the incidence of candidal vulvovaginitis in pregnant females, both with and without diabetes. Study design: Cross-sectional study conducted in Out-patient obstetrics clinic at Fatima Memorial Hospital (FMH), Lahore. Materials and Method: Sampling technique was Non-probability purposive sampling. 150 female subjects (non-diabetic= 75 and Diabetic = 75) of 18-45 years of age were included in the study. Their history was recorded and sterile speculum examination was carried out to collect vaginal swabs. Swabs were cultured on blood agar to find the organism. Glycemic control was measured by estimating HbA1c. Results: There was no significant difference in the age of both groups. Among the diabetics, 45% of the cases developed VVC as compared to the non diabetic group in which only 27% were having the condition (p<0.05). No difference in terms of symptoms was witnessed between both of the study groups (P >0.05). Vaginal culture came out to be positive in 36% of the study subjects. Glycemic control according to HbA1c levels in majority was average (55%). Candidal vulvovaginitis was more common in cases with average blood sugar control as compared to those with good glycemic control. The likelihood ratio was found to be 25.35 by chi square test (p < 0.0001). Conclusion: VVC is more frequent among diabetic pregnant patients and is directly correlated with blood sugar level.