Associations between intravaginal practices and disrupted vaginal flora in women with normal vaginal flora at baseline.

OR from two-stage random effects meta-analysis based on ordered logistic regression.aBaseline category for intravaginal practices is no vaginal practice or use of water only. Intravaginal practices measured at baseline.bDisrupted vaginal flora as a three-level ordered categorical variable: normal vaginal flora defined as Nugent score 0–3, or Ison-Hay grade I; intermediate vaginal flora defined as Nugent score 4–6, or Ison-Hay grade II; BV defined as Nugent score 7–10, or Ison-Hay grade III. Excludes two studies that did not use Gram stain criteria [19],[20].cNumber with normal flora at baseline who developed disrupted vaginal flora includes both women using and not using each intravaginal practice.dAdjusted for age, marital status, and reported number of sex partners in last 3 mo as reported at cohort entry.