2014
DOI: 10.1111/1471-0528.13115
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The vaginal microbiome, vaginal anti‐microbial defence mechanisms and the clinical challenge of reducing infection‐related preterm birth

Abstract: Ascending bacterial infection is implicated in about 40-50% of preterm births. The human vaginal microbiota in most women is dominated by lactobacilli. In women whose vaginal microbiota is not lactobacilli-dominated anti-bacterial defence mechanisms are reduced. The enhanced proliferation of pathogenic bacteria plus degradation of the cervical barrier increase bacterial passage into the endometrium and amniotic cavity and trigger preterm myometrial contractions. Evaluation of protocols to detect the absence of… Show more

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Cited by 141 publications
(123 citation statements)
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“…Ascending colonization from the vagina has been alternatively hypothesized as a potential origin largely in part due to its anatomical proximity to the intrauterine environment and its association with preterm birth. 65,66 However, as aforementioned, the vagina tends to predominately be populated by Lactobacillus species before pregnancy, and tends to be further enriched for Lactobacilli as the pregnancy progresses. [46][47][48] Although Lactobacillus species have been detected in the placental membranes in healthy, term pregnancies by Next-Gen sequencing, 67 the overall diversity of commensal species found within the placental parenchyma, amniotic fluid and neonatal meconium suggest that the vaginal microbiome is unlikely to be the only origin for the full gamut of microbial species found within the intrauterine space.…”
Section: Impact Of Maternal Nutrition In Pregnancy On Offspring Gut Mmentioning
confidence: 97%
“…Ascending colonization from the vagina has been alternatively hypothesized as a potential origin largely in part due to its anatomical proximity to the intrauterine environment and its association with preterm birth. 65,66 However, as aforementioned, the vagina tends to predominately be populated by Lactobacillus species before pregnancy, and tends to be further enriched for Lactobacilli as the pregnancy progresses. [46][47][48] Although Lactobacillus species have been detected in the placental membranes in healthy, term pregnancies by Next-Gen sequencing, 67 the overall diversity of commensal species found within the placental parenchyma, amniotic fluid and neonatal meconium suggest that the vaginal microbiome is unlikely to be the only origin for the full gamut of microbial species found within the intrauterine space.…”
Section: Impact Of Maternal Nutrition In Pregnancy On Offspring Gut Mmentioning
confidence: 97%
“…90 When the balance among bacterial species within this environment is altered, antibacterial defense mechanisms lose their efficacy leading to pathogenic bacteria proliferation. 90 For instance, reduction in the number of vaginal lactobacilli and their antimicrobial properties (such as lysostaphin expression in order to cleave the cell wall of S. aureus thus inhibiting its growth), 91 and H 2 O 2 production, 92 cause bacterial vaginosis, the most common symptomatic microbial imbalance. 93 In patients affected by bacterial vaginosis, lactobacilli are replaced by Gardnerella vaginalis, 92 94 Candida (C.) albicans, 95 S. aureus, 91 96 Neisseria gonorrhoeae 40 or other anaerobic bacteria.…”
Section: Vaginal Colonisationmentioning
confidence: 99%
“…Enterococcus, Streptococcus ) have been isolated from the placenta and amniotic cavity (DiGiulio, 2012; Solt, 2015). Vaginal microbes have also been isolated in intrauterine samples (Witkin, 2014) suggesting that organisms from the vagina may ascend into the intrauterine cavity from the vaginal canal. Further research is needed to explore a potential prenatal maternal-fetal exchange of microbes.…”
Section: Prenatal Considerationsmentioning
confidence: 99%