Prevalence of bacterial vaginosis among pregnant women attending antenatal care in low‐ and middle‐income countries between 2000 and 2020: A systematic review and meta‐analysis

Abstract Background Bacterial vaginosis increases risk of preterm birth and low birthweight, adverse pregnancy outcomes that disproportionately affect low‐ and middle‐income countries (LMICs). Objectives We aimed to estimate the prevalence of bacterial vaginosis among pregnant women attending antenatal care in LMICs between 2000 and 2020. Search Strategy We conducted a systematic review of PubMed, Embase and five regional databases. Selection Criteria We included studies conducted in LMICs and published between 2000 and 2020 in which bacterial vaginosis prevalence was reported among pregnant women attending antenatal care. Data Collection and Analysis We corrected point estimates and applied random‐effects models to generate pool prevalence estimates. We carried out subgroup analyses by study year, country‐income level, HIV prevalence, sample size, diagnostic method, trimester of pregnancy, presence of symptoms at diagnosis and risk of bias. Main Results Of 1132 publications, 74 studies met inclusion criteria, contributing 80 data points from 46 661 pregnant women. Overall pooled mean prevalence across LMICs was 15.7%. Regional prevalence ranged from 25.1% in sub‐Saharan Africa to 7.4% in Central and Southern Asia. Prevalence was 33.4% in studies where HIV prevalence was ≥10%, and 6.6% in which HIV prevalence was