ResearchObstetricsMycoplasma, bacterial vaginosis–associated bacteria BVAB3, race, and risk of preterm birth in a high-risk cohort
Section snippets
Study population and sample collection
Vaginal fluid for Gram stains and clinical data were collected as part of a multicenter, randomized trial of ultrasound-indicated cerclage for preterm birth prevention.11 Women with a singleton gestation and at least 1 previous spontaneous preterm birth of 17-33 weeks' gestation were eligible for enrollment. Cervical length was measured at the initial sonographic cervical length evaluation, which was scheduled between 16 and 21 weeks' gestation. At the visit, a sterile speculum examination was
Results
As expected, because of the entry criteria of the study (at least 1 prior preterm birth; see Materials and Methods), the proportion of women with a preterm birth less than 37 weeks in this population was very high, with blacks having significantly higher rates of preterm birth than Hispanics or whites as well as significantly higher rates of cervical shortening (<25 mm). Smoking and douching habits also differed significantly by race (Table 1).
The overall prevalence of selected bacterial taxa
Comment
In an analysis of vaginal specimens collected from black, white, and Hispanic women at high risk of preterm birth between 17 and 22 weeks' gestation, we made several observations that give insight into the effect of selected vaginal taxa on the risk of preterm birth. First, we identified a protective effect of BVAB3 on the risk of preterm birth; BVAB3 was previously associated with BV.7 The effect was robust to adjustment for racial/ethnic group and cervical shortening to less than 25 mm. We
References (24)
- et al.
Epidemiology and causes of preterm birth
Lancet
(2008) - et al.
Is a change in the vaginal flora associated with an increased risk of preterm birth?
Am J Obstet Gynecol
(2005) - et al.
Vaginal and oral microbes, host genotype and preterm birth
Med Hypotheses
(2009) - et al.
Multicenter randomized trial of cerclage for preterm birth prevention in high-risk women with shortened midtrimester cervical length
Am J Obstet Gynecol
(2009) - et al.
Amniotic fluid and maternal race influence responsiveness of fetal membranes to bacteria
J Reprod Immunol
(2012) - et al.
Births: preliminary data for 2011
DHHS Publication no. (PHS) 2013-1120. Natl Vital Stat Rep
(2012) - National Center for Health Statistics. Final natality data. 2012. Available at: www.marchofdimes.com/peristats....
- et al.
Vaginal microbial flora and outcome of pregnancy
Arch Gynecol Obstet
(2010) - et al.
Failure of metronidazole to prevent preterm delivery among pregnant women with Asymptomatic Trichomonas vaginalis infection
N Engl J Med
(2001) - et al.
Antibiotics for treating bacterial vaginosis in pregnancy
Cochrane Database Syst Rev
(2013)
Risks for acquisition of bacterial vaginosis among women who report sex with women: a cohort study
PLoS One
Targeted PCR for detection of vaginal bacteria associated with bacterial vaginosis
J Clin Microbiol
Cited by (58)
Bacterial Vaginosis: Effects on reproduction and its therapeutics
2021, Journal of Gynecology Obstetrics and Human ReproductionCitation Excerpt :However, about 50% of women with BV are asymptomatic. BV is characterized by an environment shift from a Lactobacillus-dominating mixture to a facultative and strict anaerobic polymicrobial mixture, which particularly includes Gardnerella [34], Atopobium [35], Mobiluncus [36], Prevotella [37], Mycoplasma, Ureaplasma [38], Sneathia, Leptotrichia [39], Streptococcus, Dialister, Bacteroides, etc [40–42]. In recent years, new diagnostic methods of BV have been continuously established.
A specific bacterial DNA signature in the vagina of Australian women in midpregnancy predicts high risk of spontaneous preterm birth (the Predict1000 study)
2021, American Journal of Obstetrics and GynecologyCitation Excerpt :Studies with a similar interest as ours that have employed holistic, vaginal microbial community profiling approaches have shown mixed success, with PTB associations typically being ethnicity and/or population specific. Associations between vaginal Mycoplasma spp and PTB have been reported by Wen et al13 and Foxman et al12 in cohorts of African American and Hispanic women, whereas DiGiulio et al10 reported associations between low abundance of Lactobacillus spp, high abundance of Gardnerella spp, and high abundance of Ureaplasma spp and PTB. Callahan et al16 replicated these data to some extent in another cohort of white women, again finding a significant link between PTB and low or high Lactobacillus/Gardnerella spp, and a nonsignificant trend toward high Ureaplasma spp and PTB.
Vaginal microbiome diversity and preterm birth: results of a nested case–control study in Peru
2020, Annals of EpidemiologyCitation Excerpt :However, interventions targeting BV have been unsuccessful [6,8]. Next-generation sequencing technologies make it possible to characterize complex microbial communities associated with PTB [9–12]. However, findings from studies deploying these novel methods have been inconsistent, due in part to differences in study design, populations studied, and bioinformatics and statistical analytical techniques [2,13–15].
Vaginal microbiota profile at the time of embryo transfer does not affect live birth rate in IVF cycles with donated oocytes
2019, Reproductive BioMedicine OnlineCitation Excerpt :By sequencing the 16S ribosomal RNA gene, Hyman et al. showed temporal variability over the course of IVF treatment and a correlation between composition on the day of embryo transfer and live birth rate (Hyman et al. 2012). Foxman et al. found a significant correlation between the presence of species associated with bacterial vaginosis (Mycoplasma spp., Mobiluncus and Atopobium) and a higher risk of preterm birth (Foxman et al. 2014). In a study of 867 women undergoing IVF, Ralph et al. found a higher risk of early pregnancy loss in women with bacterial vaginosis, even though conception rates were not significantly decreased (Ralph et al. 1999).
Ecological dynamics of the vaginal microbiome in relation to health and disease
2019, American Journal of Obstetrics and Gynecology
This study was supported by grant R01 HD038098 from the National Institutes of Health (D.M. and B.F., principal investigators).
The authors report no conflict of interest.
Cite this article as: Foxman B, Wen A, Srinivasan U, et al. Mycoplasma, bacterial vaginosis–associated bacteria BVAB3, race, and risk of preterm birth in a high-risk cohort. Am J Obstet Gynecol 2014;210:226.e1-7.