Association between bacterial vaginosis prevalence and maternal characteristics in pregnant women: Diagnostic comparison of BV Rapid Blue and Amsel’s criteria

BACKGROUND: Bacterial vaginosis (BV) is a common vaginal infection associated with adverse pregnancy outcomes and increased susceptibility to sexually transmitted infections. This study evaluated the diagnostic performance of the BV Rapid Blue point-of-care test compared with Amsel's criteria and assessed maternal characteristics and pregnancy outcomes among BV-positive pregnant women at Dr. Slamet Regional Hospital, Garut. METHOD: A cross-sectional diagnostic accuracy study was conducted among 131 pregnant women between April and May 2025. The diagnostic performance of BV Rapid Blue was evaluated using Amsel's criteria as the pragmatic clinical reference standard. Diagnostic accuracy parameters were calculated, and multivariate logistic regression was performed to identify factors associated with BV. RESULTS: BV prevalence was 61.1%. Most participants were aged 25-35, multigravida, and had high school education. All participants reported vaginal discharge, while only 3.1% reported a history of STIs. Common complications included preeclampsia (46.6%) and PROM (32.1%). BV Rapid Blue showed strong agreement with Amsel's criteria (p < 0.0001), with sensitivity 95.4%, specificity 55.7%, PPV 51.3%, and NPV 96.1%. BV recurrence (OR = 4.29, p < 0.0001) and secondary infection (OR = 2.56, p = 0.01) were significant predictors, while higher education was protective (OR = 0.52, p = 0.02). CONCLUSIONS: BV remains prevalent in pregnancy. BV Rapid Blue is a reliable, rapid diagnostic tool with high sensitivity and NPV. Early diagnosis may facilitate earlier clinical assessment and management, particularly in settings where laboratory-based diagnostics are limited.