A Systematic Review of Estimated Signs, Symptoms, and Risks Associated With Vaginal Candidiasis in Pregnancy: The Integration of A Traditional Approach and Personalized Self-assessment Questionnaire

Background: This review aimed to implement a search strategy focused on vaginal candida infections in pregnant women and to analyze specific vulvovaginal symptom questionnaires (VSQs) for Candida infections. Methods: A literature review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The MEDLINE, Web of Science, and Scopus databases were searched for studies published between 1997 and 2023. The search strategy included keywords related to vaginal candidiasis, pregnancy, risk factors, symptoms, and self-assessment VSQs. The studies were assessed for quality using Joanna Briggs Institute Critical Appraisal Tools, focusing on validity, reliability, and appropriate statistical methods. Results: A total of 36 papers with vaginal candidiasis reported during pregnancy were included (1997–2023), along with 14 papers reporting the use of VSQs. The literature was found to lack sufficient data, with a wide variation in population size and data across studies. Sample sizes ranged from as few as 80 patients to as many as 13,863 patients in other studies. Notably, a significant age range was observed among the participants, spanning from 10 to 64 years. Additionally, symptoms and signs were not investigated in 17 studies, while risk factors were not discussed in 20 studies. A total of 14 studies were identified; however, only one was presented with a fully developed VSQ, which had been validated and was available in multiple languages. Meanwhile, none of the studies focused on pregnant women and the role of VSQs. Conclusions: Incorporating self-assessment VSQs into clinical practice would improve everyday practice and increase awareness among pregnant women regarding vulvovaginal Candida infections, improve the identification and management of these infections, leading to earlier detection, more timely treatment, and improved health outcomes for newborns.