Normal flora and bacterial vaginosis in pregnancy: an overview

Redelinghuys, Mathys J; Ehlers, M.M.; Dreyer, Andries; Kock, Marleen M.

doi:10.3109/1040841x.2014.954522

Cited by 34 publications

(37 citation statements)

References 143 publications

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“…Exposure to these insults leads to a less diverse infant gut microbiome, with relatively higher numbers of pathogenic bacteria being present (Chernikova et al, ). Infections during pregnancy are well known to interrupt normal gestation by both altering the vaginal flora as in bacterial vaginosis, or by increasing susceptibilities for other infections that could alter both maternal and infant microbiomes (Redelinghuys et al, ). Other prenatal factors of importance include antibiotics and prenatal steroids.…”

Section: Part Imentioning

confidence: 99%

The very low birth weight infant microbiome and childhood health

Groër

Gregory

Louis‐Jacques

et al. 2015

Birth Defects Research Pt C

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This review describes current understandings about the nature of the very low birth weight infant (VLBW) gut microbiome. VLBW infants often experience disruptive pregnancies and births, and prenatal factors can influence the maturity of the gut and immune system, and disturb microbial balance and succession. Many VLBWs experience rapid vaginal or Caesarean births. After birth these infants often have delays in enteral feeding, and many receive little or no mother's own milk. Furthermore the stressors of neonatal life in the hospital environment, common use of antibiotics, invasive procedures and maternal separation can contribute to dysbiosis. These infants experience gastrointestinal dysfunction, sepsis, transfusions, necrotizing enterocolitis, oxygen toxicity, and other pathophysiological conditions that affect the normal microbiota. The skin is susceptible to dysbiosis, due to its fragility and contact with NICU organisms. Dysbiosis in early life may resolve but little is known about the timing of the development of the signature gut microbiome in VLBWs. Dysbiosis has been associated with a number of physical and behavioral problems, including autism spectrum disorders, allergy and asthma, gastrointestinal disease, obesity, depression, and anxiety. Dysbiosis may be prevented or ameliorated in part by prenatal care, breast milk feeding, skin to skin contact, use of antibiotics only when necessary, and vigilance during infancy and early childhood.

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Section: Part Imentioning

confidence: 99%

The very low birth weight infant microbiome and childhood health

Groër

Gregory

Louis‐Jacques

et al. 2015

Birth Defects Research Pt C

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“…Lactobacilli-dominance and low pH of the human vaginal microbiome are hypothesized to benefit women by reducing disease risk (reviewed in Brotman, 2011; Graver and Wade, 2011; O'Hanlon et al, 2011; Gong et al, 2014; Nunn et al, 2015). Furthermore, the loss of lactobacilli-dominance is linked to bacterial vaginosis (BV), which is associated with an overgrowth of anaerobic bacteria, relatively high vaginal pH (>4.5; Aldunate et al, 2015), infertility, preterm birth, maternal infections, and increased risk of sexually transmitted diseases (Cherpes et al, 2003; Leitich et al, 2003; Atashili et al, 2008; Brotman et al, 2010; van Oostrum et al, 2013; DiGiulio et al, 2015; Redelinghuys et al, 2016). The fact that the human vaginal microbiome appears to be unique among mammals raises key questions about why humans are different: Do humans have a distinct reproductive physiology or experience different or stronger forces of selection compared to other mammals?…”

Section: Introductionmentioning

confidence: 99%

Lactobacilli Dominance and Vaginal pH: Why Is the Human Vaginal Microbiome Unique?

et al. 2016

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The human vaginal microbiome is dominated by bacteria from the genus Lactobacillus, which create an acidic environment thought to protect women against sexually transmitted pathogens and opportunistic infections. Strikingly, lactobacilli dominance appears to be unique to humans; while the relative abundance of lactobacilli in the human vagina is typically >70%, in other mammals lactobacilli rarely comprise more than 1% of vaginal microbiota. Several hypotheses have been proposed to explain humans' unique vaginal microbiota, including humans' distinct reproductive physiology, high risk of STDs, and high risk of microbial complications linked to pregnancy and birth. Here, we test these hypotheses using comparative data on vaginal pH and the relative abundance of lactobacilli in 26 mammalian species and 50 studies (N = 21 mammals for pH and 14 mammals for lactobacilli relative abundance). We found that non-human mammals, like humans, exhibit the lowest vaginal pH during the period of highest estrogen. However, the vaginal pH of non-human mammals is never as low as is typical for humans (median vaginal pH in humans = 4.5; range of pH across all 21 non-human mammals = 5.4–7.8). Contrary to disease and obstetric risk hypotheses, we found no significant relationship between vaginal pH or lactobacilli relative abundance and multiple metrics of STD or birth injury risk (P-values ranged from 0.13 to 0.99). Given the lack of evidence for these hypotheses, we discuss two alternative explanations: the common function hypothesis and a novel hypothesis related to the diet of agricultural humans. Specifically, with regard to diet we propose that high levels of starch in human diets have led to increased levels of glycogen in the vaginal tract, which, in turn, promotes the proliferation of lactobacilli. If true, human diet may have paved the way for a novel, protective microbiome in human vaginal tracts. Overall, our results highlight the need for continuing research on non-human vaginal microbial communities and the importance of investigating both the physiological mechanisms and the broad evolutionary processes underlying human lactobacilli dominance.

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“…As the prevalence of preterm births is increasing there is a need to find out all possible risk factors so that timely measures can be taken to prevent women delivering a preterm baby. Pregnancy itself is known to alter the vaginal flora and predisposes to BV which many at times goes undetected because many women are asymptomatic [14]. Our study reports a strong association of BV with preterm birth and the condition is very easy to treat by antibiotics, hospital protocols should screen all pregnant women early in pregnancy to prevent preterm birth.…”

Section: Discussionmentioning

confidence: 65%

Bacterial Vaginosis as a Risk Factor for Preterm Labour-An Analysis of Age and Duration of Marriage

Saadia¹

2016

JGO

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Preterm labour is the onset of labour between ≥ 24 weeks to < 37 weeks of gestation. Bacterial Vaginosis (BV) is a polymicrobial condition with predominant lactobacilli in the vaginal flora. It is an important risk factor for preterm labour with an incidence of 5-18% of all deliveries causing increased perinatal morbidity and mortality with subsequent neurodevelopmental problems as cerebral palsy. We aimed to determine the association of BV with preterm labour population. A case control study was conducted comparing the prevalence of bacterial vaginosis in women having term labour with those who had preterm delivery. Chi square test was used to compare differences in participants' age, duration of pregnancy and duration of marriage. Odd ratio and CI was calculated for the association between BV and preterm labour. Nearly half of the participants that experienced preterm labour were between 21 and 25 years old (46.7%, n = 35) and nearly half of the participants that experienced term pregnancy were between 21 and 25 years old as well (48.0%, n = 36). Additionally, the majority of participants had been married for three to four years, for those that experienced preterm labour (64.0%, n = 48) and term pregnancy (52.0%, n = 39). Furthermore, nearly half of the participants' duration of pregnancy was between 33 and 34 weeks (49.3%, n = 37) and 52.0% of participants who experienced term pregnancy had been pregnant for 37 to 38 weeks (n = 39). Women with Bacterial Vaginosis, experienced preterm labour in 26.7% cases (n = 20) as compared to those who had term pregnancy 12.0% (n = 9). BV was significantly associated with preterm labour (OR=7.3, 95% CI =1.9-27.5, P=0.003). There was no significant difference in participants' age between preterm labour and term pregnancy groups, (p value=0.880). Additionally, there was no significant difference in participants' duration of marriage between preterm labour and term pregnancy groups, (p value=0.801). Bacterial Vaginosis is a risk factor for preterm labor. The study also concluded that there is no significant association between age, duration of pregnancy and duration of marriage between preterm labour and term pregnancy groups.

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Normal flora and bacterial vaginosis in pregnancy: an overview

Cited by 34 publications

References 143 publications

The very low birth weight infant microbiome and childhood health

The very low birth weight infant microbiome and childhood health

Lactobacilli Dominance and Vaginal pH: Why Is the Human Vaginal Microbiome Unique?

Bacterial Vaginosis as a Risk Factor for Preterm Labour-An Analysis of Age and Duration of Marriage

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