Vaginose bactérienne et prématurité spontanée

Brabant, G.

doi:10.1016/j.jgyn.2016.09.014

Cited by 30 publications

(8 citation statements)

References 59 publications

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“…The prevalence of vaginal bacteriosis varies widely between populations. 34 39 44 45 46 In our population, it was significantly higher than in mainland France 23.1 versus 15.2%; p = 0.006.…”

Section: Discussioncontrasting

confidence: 55%

“…In our study, the prevalence of G.vaginalis was 23.1% (75/325), and the infection was associated with a 2-fold increase of the odds ratio for extreme/severe preeclampsia which is similar to what has been observed in a previous meta-analysis showing odds ratios ranging between 1.5 and 2. 39 40 The hypothesized pathophysiology of the association is that the infections leads to the fragilization of the membranes which are at increased risk of rupture. It was also suggested that cytokines in infected women may lead to uterine contractions.…”

Section: Discussionmentioning

confidence: 99%

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Risk Factors for Very Preterm Births in French Guiana: The Burden of Induced Preterm Birth

Leneuve‐Dorilas

Favre

Louis

et al. 2019

AJP Rep

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Background Early preterm births are still represented as a major public health problem in French Guiana. The objective of the present study was to study factors associated with early preterm birth in French Guiana. Methods A monocentric age-matched case control study was conducted at the sole level 3 maternity in French Guiana. In utero fetal deaths and multiple pregnancies were not included. Cases were defined as giving birth prematurely between 22 and 32 weeks of pregnancy. Controls were defined as women delivering on term. For each case three controls were matched on age. In utero deaths, medical pregnancy interruptions and multiple pregnancies (a known major cause of preterm delivery) were excluded from the study. Sociodemographic variables, medical and obstetrical history, the complications of the current pregnancy, and the results of the last vaginal swab before delivery were recorded in the second or the third trimester. Thematic conditional logistic regression models were computed. Results Overall 94 cases and 282 matched controls were included. Preterm delivery was spontaneous in 47.9% (45/94) of the cases and induced in 52.1% (49/94).A history of preterm birth was associated with both spontaneous and induced preterm delivery. The absence of health insurance was associated with spontaneous early preterm delivery AOR (adjusted odd ratio) = 9.1 (2.2–38.3), p = 0.002 but not induced preterm delivery adjusted odd ratio (AOR) = 2.1 (0.6–6.7), p = 0.2. Gravidic hypertension, placenta praevia, intrauterine growth retardation and mostly preeclampsia (66%, 32/49) were linked to induced preterm delivery but not spontaneous delivery. Gardnerellavaginalis and group B Streptococcus infections were significantly associated with induced early preterm delivery but not spontaneous early preterm delivery. Conclusions Social factors were associated with spontaneous early preterm delivery, suggesting that efforts to reduce psychosocial stressors could lead to potential improvements. Vaginal infections were also associated with induced preterm labor suggesting that early diagnosis and treatment could reduce induced early preterm delivery. Preeclampsia was a major contributor to induced early preterm delivery. Reliable routine predictors of preeclampsia are still not available which makes its prevention impossible in first pregnancies.

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Section: Discussioncontrasting

confidence: 55%

Section: Discussionmentioning

confidence: 99%

Risk Factors for Very Preterm Births in French Guiana: The Burden of Induced Preterm Birth

Leneuve‐Dorilas

Favre

Louis

et al. 2019

AJP Rep

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“…The results from this study suggest that G . vaginalis , the most common bacteria associated with BV [ 4 , 5 ], has the ability to initiate cervical remodeling through multiple biological, molecular and biomechanical mechanisms. In this study, we successfully generated a novel pregnant mouse model with a CV space colonized with G .…”

Section: Discussionmentioning

confidence: 99%

“…vaginalis . Studies showing varying associations between BV treatment and PTB rates [ 4 ] may suggest that, in human pregnancy, G . vaginalis alone may not be sufficient to cause sPTB.…”

Section: Discussionmentioning

confidence: 99%

“…Despite ongoing research, there are no effective strategies to predict or prevent the majority of preterm births. Recently, studies focusing on the causes of PTB have shown that women with bacterial vaginosis (BV) are at higher risk for spontaneous PTB (sPTB) [ 4 – 6 ]. BV is the most common genital tract infection affecting women worldwide [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

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Colonization of the cervicovaginal space with Gardnerella vaginalis leads to local inflammation and cervical remodeling in pregnant mice

et al. 2018

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The role of the cervicovaginal (CV) microbiome in regulating cervical function during pregnancy is poorly understood. Gardnerella vaginalis (G. vaginalis) is the most common bacteria associated with the diagnosis of bacterial vaginosis (BV). While BV has been associated with preterm birth (PTB), clinical trials targeting BV do not decrease PTB rates. It remains unknown if G. vaginalis is capable of triggering molecular, biomechanical and cellular events that could lead to PTB. The objective of this study was to determine if cervicovaginal colonization with G. vaginalis, in pregnant mice, induced cervical remodeling and modified cervical function. CD-1 timed-pregnant mice received a 5X108 CFU/mL intravaginal inoculation of G. vaginalis or control on embryonic day 12 (E12) and E13. On E15, the mice were sacrificed and cervicovaginal fluid (CVF), amniotic fluid (AF), cervix, uterus, placentas and fetal membranes (FM) were collected. Genomic DNA was isolated from the CVF, placenta, uterus and FM and QPCR was performed to confirm colonization. IL-6 was measured in the CVF and AF and soluble e-cadherin (seCAD) was assessed in the CVF by ELISA. RNA was extracted from the cervices to evaluate IL-10, IL-8, IL-1β, TNF-α, Tff-1, SPINK-5, HAS-1 and LOX expression via QPCR. Mucicarmine and trichrome staining was used to assess cervical mucin and collagen. Biomechanical properties of the cervix were studied using quasi-static tensile load-to-failure biomechanical tests. G. vaginalis successfully colonized the CV space. This colonization induced immune responses (increased IL-6 levels in CVF and AF, increased mRNA expression of cervical cytokines), altered the epithelial barrier (increased seCAD in the CVF), induced cervical remodeling (increased mucin production, altered collagen) and altered cervical biomechanical properties (a decrease in biomechanical modulus and an increase in maximum strain). The ability of G. vaginalis to induce these molecular, immune, cellular and biomechanical changes suggests that this bacterium may play a pathogenic role in premature cervical remodeling leading to PTB.

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Treatment of bacterial vaginosis before 28 weeks of pregnancy to reduce the incidence of preterm labor

Rebouças

Eleutério

Peixoto

et al. 2019

Intl J Gynecology & Obste

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Background: Controversy exists regarding the benefits of treating bacterial vaginosis (BV) during pregnancy to reduce the incidence of preterm labor (PTL). Objectives:To evaluate whether treatment of BV with vaginal clindamycin or oral metronidazole before 28 weeks of pregnancy reduces PTL incidence.Search strategy: PubMed, Scopus, Web of Science, Science Direct, CENTRAL, and SciELO databases were searched until December 30, 2017. Search terms included "bacterial vaginosis" and "preterm labor." No language restrictions were applied. Selection criteria:Randomized clinical trials that evaluated treatment of BV with clindamycin or metronidazole to reduce PTL incidence. Data collection and analysis:The risk of PTL was evaluated by the odds ratio (OR) and 95% confidence interval (CI). Dichotomous data from each study were combined for meta-analysis using the Mantel-Haenszel model. Main results:Nine reports were included in the systematic review, with eight reports included in the meta-analysis. No reduction in the incidence of PTL was found for either metronidazole (OR 0.94, 95% CI 0.71-1.25) or clindamycin (OR 1.01, 95% CI 0.75-1.36).Conclusions: Use of oral metronidazole or vaginal clindamycin to treat BV before 28 weeks of pregnancy did not reduce the incidence of PTL.

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Vaginose bactérienne et prématurité spontanée

Cited by 30 publications

References 59 publications

Risk Factors for Very Preterm Births in French Guiana: The Burden of Induced Preterm Birth

Risk Factors for Very Preterm Births in French Guiana: The Burden of Induced Preterm Birth

Colonization of the cervicovaginal space with Gardnerella vaginalis leads to local inflammation and cervical remodeling in pregnant mice

Treatment of bacterial vaginosis before 28 weeks of pregnancy to reduce the incidence of preterm labor

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