Characterisation of the vaginal Lactobacillus microbiota associated with preterm delivery

Abstract

The presence of an abnormal vaginal microflora in early pregnancy is a risk factor for preterm delivery. There is no investigation on vaginal flora dominated by lactic acid bacteria and possible association with preterm delivery. We assessed the dominant vaginal Lactobacillus species in healthy pregnant women in early pregnancy in relation to pregnancy outcome. We observed 111 low risk pregnant women with a normal vaginal microflora 11 + 0 to 14 + 0 weeks of pregnancy without subjective complaints. Vaginal smears were taken for the identification of lactobacilli using denaturing gradient gel electrophoresis (DGGE). Pregnancy outcome was recorded as term or preterm delivery (limit 36 + 6 weeks of gestation). The diversity of Lactobacillus species in term vs. preterm was the main outcome measure. L. iners alone was detected in 11 from 13 (85%) women who delivered preterm. By contrast, L. iners alone was detected in only 16 from 98 (16%) women who delivered at term (p < 0.001). Fifty six percent women that delivered at term and 8% women that delivered preterm had two or more vaginal Lactobacillus spp. at the same time. This study suggests that dominating L. iners alone detected in vaginal smears of healthy women in early pregnancy might be associated with preterm delivery.

Association between Obesity and Cervical Microflora Dominated by Lactobacillus iners in Korean Women

“…Furthermore, several previous studies showed that prepregnancy body mass index (BMI) and plasma leptin levels may influence the outcomes of pregnancies, such as preterm delivery, low-birth-weight infants, macrosomia, and delivery disorders (12,13). These obstetric and neonatal disorders were also associated with Lactobacillus inersdominant microbiota in early pregnancy and the presence of bacteria related to bacterial vaginosis, as detected by vaginal smears (8,(14)(15)(16). To the best of our knowledge, no study to date has examined the relationship between obesity and Lactobacillus composition in the reproductive tract.…”

“…An abnormal vaginal microflora in pregnant women is a risk factor for preterm delivery, and the dominance of L. iners in vaginal smears from healthy women during early pregnancy is associated with preterm delivery (8,14). Women with large proportions of L. crispatus had high Escherichia coli inhibitory activity, whereas women whose vaginal smears were dominated by L. iners had low E. coli inhibitory activity (15).…”

“…Women whose genital microbial florae are dominated by lactobacilli also have lower risks of contracting sexually transmitted diseases, such as those caused by human immunodeficiency virus (HIV), herpes simplex virus type 2, human papillomavirus (HPV), and Chlamydia trachomatis (5)(6)(7). In addition, colonization by lactobacilli has been shown to be correlated with lower risks for pelvic inflammatory disease and pregnancy-related complications (1,8).…”

Treatment of Bacterial Vaginosis in Early Pregnancy and its Effect on Spontaneous Preterm Delivery and Preterm Premature Rupture of Membranes

“…have shown that women with Lactobacillus iners have a greater risk of preterm delivery than women with other types of lactobacillus spp. [16]. He has also shown that different lactobacillus can restore the vaginal flora after antibiotic treatment of BV [17].…”

Current views on vaginal microbiota and its impact on pregnancy outcomes

“…Это при-водит к размножению анаэробов, ассоцииро-ванных с БВ. Таким образом, преобладание L. iners часто наблюдается в переходный этап между нормальным состоянием влагалищного микробиоценоза и нарушенным и может пред-располагать к развитию патогенной влагалищ-ной микрофлоры, что, в свою очередь, может быть потенциально связано с невынашивани-ем беременности и преждевременными родами [15,16,20].…”