Association of Gardnerella vaginalis and Lactobacillus with recurrent abortion in a sample of Iraqi women

Bacterial vaginosis is a prevalent genital condition in sexually active women globally, affecting 23–29%. It is characterized by an imbalance in the vaginal microbiota, with a rise in facultative organisms such as Gardnerella and a decrease in beneficial Lactobacillus spp. This study investigated the association between bacterial vaginosis and spontaneous miscarriage and assessed whether Lactobacillus influences outcomes using bacteriological techniques. The research was conducted at several hospitals and laboratories between December 2023 and August 2024. Fifty-five women who underwent legal abortion due to intrauterine fetal death were included. Vaginal swabs were collected from each patient and analyzed by Gram stain and culture on different agar media. Gardnerella vaginalis was present in 24 of 55 cases, with the highest occurrence in the second trimester (30.9%), followed by the third (7.3%), and the lowest in the first trimester; this difference was statistically significant (𝑝 < 0.05). In contrast, Lactobacillus spp. was identified in 19 samples; this was not statistically significant (𝑝 > 0.05). These findings suggest that the vaginal microbiome may contribute to miscarriage risk and highlight the need to clarify this relationship.