Shift in Vaginal Flora (Bacterial Vaginosis) and the Frequency of Chorioamnionitis in a High-Risk Population

Takei, Hiroyuki; Ruiz, Bernardo

doi:10.1159/000325983

Cited by 5 publications

(3 citation statements)

References 19 publications

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“…The absence of Lactobacillus spp. and polymicrobial colonisation of the vagina have long been recognised as a risk factor for PPROM [ 27 ], preterm birth [ 28 – 31 ] and histological chorioamnionitis [ 32 – 34 ]. Despite a well-described infectious aetiology and high prevalence of chorioamnionitis in PPROM patients, the few studies to have examined vaginal bacterial composition in women with PPROM are limited to small sample sizes collected only after membrane rupture [ 35 – 37 ].…”

Section: Introductionmentioning

confidence: 99%

Vaginal dysbiosis increases risk of preterm fetal membrane rupture, neonatal sepsis and is exacerbated by erythromycin

Brown

Marchesi

Lee

et al. 2018

BMC Med

228

215

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BackgroundPreterm prelabour rupture of the fetal membranes (PPROM) precedes 30% of preterm births and is a risk factor for early onset neonatal sepsis. As PPROM is strongly associated with ascending vaginal infection, prophylactic antibiotics are widely used. The evolution of vaginal microbiota compositions associated with PPROM and the impact of antibiotics on bacterial compositions are unknown.MethodsWe prospectively assessed vaginal microbiota prior to and following PPROM using MiSeq-based sequencing of 16S rRNA gene amplicons and examined the impact of erythromycin prophylaxis on bacterial load and community structures.ResultsIn contrast to pregnancies delivering at term, vaginal dysbiosis characterised by Lactobacillus spp. depletion was present prior to the rupture of fetal membranes in approximately a third of cases (0% vs. 27%, P = 0.026) and persisted following membrane rupture (31%, P = 0.005). Vaginal dysbiosis was exacerbated by erythromycin treatment (47%, P = 0.00009) particularly in women initially colonised by Lactobacillus spp. Lactobacillus depletion and increased relative abundance of Sneathia spp. were associated with subsequent funisitis and early onset neonatal sepsis.ConclusionsOur data show that vaginal microbiota composition is a risk factor for subsequent PPROM and is associated with adverse short-term maternal and neonatal outcomes. This highlights vaginal microbiota as a potentially modifiable antenatal risk factor for PPROM and suggests that routine use of erythromycin for PPROM be re-examined.Electronic supplementary materialThe online version of this article 10.1186/s12916-017-0999-x) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Vaginal dysbiosis increases risk of preterm fetal membrane rupture, neonatal sepsis and is exacerbated by erythromycin

Brown

Marchesi

Lee

et al. 2018

BMC Med

228

215

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“…and increased diversity of anaerobic bacteria including Prevotella, Dialister, Atopobium vaginae, Gardnerella vaginalis, Megasphaera, Peptoniphilus, Sneathia, Finegoldia , and Mobiluncus . The latter species are often associated with bacterial vaginosis, a clinical syndrome of vaginal discharge and odour characterised by polymicrobial overgrowth, which is linked to an increased risk of preterm birth89 and histological chorioamnionitis111819. Interestingly, in American populations, vaginal bacterial communities dominated by Lactobacillus spp.…”

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confidence: 99%

The vaginal microbiome during pregnancy and the postpartum period in a European population

MacIntyre

Chandiramani

Lee

et al. 2015

Sci Rep

461

429

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The composition and structure of the pregnancy vaginal microbiome may influence susceptibility to adverse pregnancy outcomes. Studies on the pregnant vaginal microbiome have largely been limited to Northern American populations. Using MiSeq sequencing of 16S rRNA gene amplicons, we characterised the vaginal microbiota of a mixed British cohort of women (n = 42) who experienced uncomplicated term delivery and who were sampled longitudinally throughout pregnancy (8–12, 20–22, 28–30 and 34–36 weeks gestation) and 6 weeks postpartum. We show that vaginal microbiome composition dramatically changes postpartum to become less Lactobacillus spp. dominant with increased alpha-diversity irrespective of the community structure during pregnancy and independent of ethnicity. While the pregnancy vaginal microbiome was characteristically dominated by Lactobacillus spp. and low alpha-diversity, unlike Northern American populations, a significant number of pregnant women this British population had a L. jensenii-dominated microbiome characterised by low alpha-diversity. L. jensenii was predominantly observed in women of Asian and Caucasian ethnicity whereas L. gasseri was absent in samples from Black women. This study reveals new insights into biogeographical and ethnic effects upon the pregnancy and postpartum vaginal microbiome and has important implications for future studies exploring relationships between the vaginal microbiome, host health and pregnancy outcomes.

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“…В IV типе влагалищного микробиома отмечена низкая относительная плотность Lactobacillus spp., при этом выявлено высокое разнообразие видов анаэробных бактерий: Prevotella, Dialister, Atopobium vaginae, Gardnerella vaginalis, Megasphaera, Peptoniphilus, Sneathia, Finegoldia и Mobiluncus. Последние из обозначенных видов микроорганизмов часто ассоциированы с клиническими симптомами бактериального вагиноза -состояния с наличием неприятного запаха и влагалищного отделяемого у женщин, что к тому же было связано с риском развития преждевременных родов [15,16] и гистологически подвержденного хориоамнионита [17,18]. Исследования, проведенные в США, показали, что в микробиоме влагалища у женщин азиатского происхождения и женщин европеоидной расы чаще преобладали Lactobacillus spp.…”

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Microbiome in obstetrics and gynecology: a reassessment of views on the microbial community of the reproductive system

Kuzmin¹,

Stoma²,

Adamyan³

2020

Infectious diseases: News, Opinions, Training

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Федеральное государственное бюджетное образовательное учреждение высшего образования «Московский государственный медикостоматологический университет имени А.И. Евдокимова» Министерства здравоохранения Российской Федерации, 127473, г. Москва, Российская Федерация 2 Учреждение образования «Белорусский государственный медицинский университет», 220116, г. Минск, Республика Беларусь

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Shift in Vaginal Flora (Bacterial Vaginosis) and the Frequency of Chorioamnionitis in a High-Risk Population

Cited by 5 publications

References 19 publications

Vaginal dysbiosis increases risk of preterm fetal membrane rupture, neonatal sepsis and is exacerbated by erythromycin

Vaginal dysbiosis increases risk of preterm fetal membrane rupture, neonatal sepsis and is exacerbated by erythromycin

The vaginal microbiome during pregnancy and the postpartum period in a European population

Microbiome in obstetrics and gynecology: a reassessment of views on the microbial community of the reproductive system

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