Mycoplasma, bacterial vaginosis–associated bacteria BVAB3, race, and risk of preterm birth in a high-risk cohort

Foxman, Betsy; Wen, Ai; Srinivasan, Usha; Goldberg, Deborah E.; Marrs, Carl F.; Owen, John; Wing, Deborah A.; Misra, Dawn P.

doi:10.1016/j.ajog.2013.10.003

Cited by 66 publications

(68 citation statements)

References 20 publications

(29 reference statements)

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“…Furthermore, using antibiotic prescriptions as a surrogate for health care utilization, antibiotics were more frequently prescribed in the non–large urban cohorts for nongenitourinary infections. Confirming negative effects seen by others (5,28,29,31), our study did not show a reduced risk for preterm birth with the non-randomized prescription of antibiotics considered active against urogenital mollicutes, possibly due to reinfection, antibacterial resistance, inadequate drug levels at site of infection, or lack of eradication secondary to non-bacteriocidal therapy (5,31,32,33,34). …”

Section: Discussionsupporting

confidence: 87%

“…In contrast, a recent Brussels study (28) of nearly 2000 pregnancies found Ureaplasma species to be a significant risk for preterm birth, and a commensurate risk of preterm birth was associated with abnormal flora, but only if Ureaplasma species was culture positive. These variable results may be related to differences in vaginal ecologies as recently described in studies of high-risk pregnancies (29,30). …”

Section: Discussionmentioning

confidence: 81%

“…In conclusion, a reasonable hypothesis remains that genetic and environmental factors coupled with infections, perhaps with a change in vaginal flora, trigger cytokines to cause amniotic inflammation, inducing preterm birth, especially before 35 weeks of gestation (2,27,28,29,31). By this study and multiple others, the infecting organisms appear, by epidemiologic associations, to be easily overlooked or difficult to detect and are usually considered commensal bacteria.…”

Section: Discussionmentioning

confidence: 99%

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Epidemiologic Factors and Urogenital Infections Associated With Preterm Birth in a Midwestern U.S. Population

Agger

Siddiqui

Lovrich

et al. 2014

Obstetrics &Amp; Gynecology

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Objective To correlate epidemiologic factors with urogenital infections associated with preterm birth. Methods Pregnant women were sequentially included from four Wisconsin cohorts: large urban, midsize urban, small city, and rural city. Demographic, clinical, and current pregnancy data were collected. Cervical and urine specimens were analyzed by microscopy, culture, and polymerase chain reaction for potential pathogens. Results Six hundred seventy-six women were evaluated. Fifty-four (8.0%) had preterm birth: 12.1% (19/157) large urban, 8.8% (15/170) midsize urban, 9.4% (16/171) small city, and 2.3% (4/178) rural city. Associated host factors and infections varied significantly among sites. Urogenital infection rates, especially Mycoplasma hominis and Ureaplasma parvum, were highest at the large urban site. Large urban site, minority ethnicity, multiple infections, and certain historical factors were associated with preterm birth by univariable analysis. By multivariable analysis, preterm birth was associated with prior preterm birth (adjusted odds ratio [aOR] 2.76, 95% confidence interval [CI] 1.27–6.02) and urinary tract infection (aOR 2.62, 95% CI 1.32–519), and negatively associated with provider-assessed good health (aOR 0.42, 95% CI 0.23–0.76) and group B streptococcal infection treatment (surrogate for healthcare utilization) (aOR 0.38, 95% CI 0.15–.99). Risk and protective factors were similar for women with birth at < 35 weeks, and additionally associated with M hominis (aOR 3.6, 95% CI 1.4–9.7). Conclusion These measured differences between sites are consistent with observations that link epidemiologic factors, both environmental and genetic, with minimally pathogenic vaginal bacteria, inducing preterm birth, especially at less than 35 weeks of gestation.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

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Epidemiologic Factors and Urogenital Infections Associated With Preterm Birth in a Midwestern U.S. Population

Agger

Siddiqui

Lovrich

et al. 2014

Obstetrics &Amp; Gynecology

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“…We tested for associations between PTB and increased gestational frequencies of several genera frequently linked with BV (Gardnerella, Prevotella, Atopobium, Mobiluncus, Megasphaera, Dialister, Peptoniphilus, and Mycoplasma) and three sequence variants that exactly matched 16S rRNA genes from the recently identified bacterial vaginosisassociated bacteria BVAB1, BVAB2, and BVAB3 (23,24). Prevotella was associated with PTB in both cohorts (P < 0.05), while most of the remaining genera were significantly associated only in the Stanford cohort (Table 1).…”

Section: Resultsmentioning

confidence: 99%

Replication and refinement of a vaginal microbial signature of preterm birth in two racially distinct cohorts of US women

Callahan

DiGiulio

Goltsman

et al. 2017

Proc. Natl. Acad. Sci. U.S.A.

327

482

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Preterm birth (PTB) is the leading cause of neonatal morbidity and mortality. Previous studies have suggested that the maternal vaginal microbiota contributes to the pathophysiology of PTB, but conflicting results in recent years have raised doubts. We conducted a study of PTB compared with term birth in two cohorts of pregnant women: one predominantly Caucasian (n = 39) at low risk for PTB, the second predominantly African American and at high-risk (n = 96). We profiled the taxonomic composition of 2,179 vaginal swabs collected prospectively and weekly during gestation using 16S rRNA gene sequencing. Previously proposed associations between PTB and lower Lactobacillus and higher Gardnerella abundances replicated in the low-risk cohort, but not in the high-risk cohort. High-resolution bioinformatics enabled taxonomic assignment to the species and subspecies levels, revealing that Lactobacillus crispatus was associated with low risk of PTB in both cohorts, while Lactobacillus iners was not, and that a subspecies clade of Gardnerella vaginalis explained the genus association with PTB. Patterns of cooccurrence between L. crispatus and Gardnerella were highly exclusive, while Gardnerella and L. iners often coexisted at high frequencies. We argue that the vaginal microbiota is better represented by the quantitative frequencies of these key taxa than by classifying communities into five community state types. Our findings extend and corroborate the association between the vaginal microbiota and PTB, demonstrate the benefits of high-resolution statistical bioinformatics in clinical microbiome studies, and suggest that previous conflicting results may reflect the different risk profile of women of black race.pregnancy | prematurity | vaginal microbiota | Lactobacillus | Gardnerella P reterm birth (PTB; delivery at <37 gestational wk) affects ≈12% of US births and is the leading cause of neonatal death and morbidity worldwide. Multiple lines of evidence support a role for the indigenous microbial communities of the mother (the maternal microbiota) in the pathophysiology of PTB. Microbial invasion of the amniotic cavity is one of the most frequent causes of spontaneous PTB (1), and the most common invading taxa are consistent with maternal origin (2-4). Bacterial vaginosis (BV), a condition involving an altered vaginal microbiota, has been consistently identified as a risk factor for PTB (5, 6). Multiple studies have also found chronic periodontitis, another condition associated with an altered microbiota, to be a risk factor for PTB (7,8).High-throughput sequencing methods have facilitated new lines of investigation into the microbial etiology of PTB (9, 10). Amplification and high-throughput sequencing of the 16S rRNA gene (metabarcoding) simultaneously measures the presence and relative abundance of thousands of bacterial taxa (composition), and resolves differences to the level of genus and sometimes species or subspecies. To date, metabarcoding studies of the relationship between the vaginal microbiota and PTB have y...

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“…Foxman et al . evaluated the role of several BV-associated bacteria with preterm birth and reported that pregnant women having this organism had a decreased risk of preterm delivery [39]. BV has been linked with increased shedding of HIV [1].…”

Section: Resultsmentioning

confidence: 99%

Mageeibacillus indolicus gen. nov., sp. nov.: A novel bacterium isolated from the female genital tract

et al. 2015

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Three isolates of a bacterium recovered from human endometrium using conventional culture methods were characterized biochemically and subjected to 16S rRNA gene sequencing and phylogenetic analysis. Isolates were non-motile, obligately anaerobic, non-spore forming, asaccharolytic, non-cellulolytic, indole positive, Gram positive rods. Cell wall fatty acid profiling revealed C14:0, C16:0, C18:2 ω6, 9c, C18:1 ω9c and C18:0 to be the major fatty acid composition. The DNA mol % G+C was determined to be 44.2%. 16S rRNA gene sequence analysis revealed only 91% sequence similarity with the closest cultivated bacterial isolate, Saccharofermentans acetigenes. Based on genotypic and phenotypic data, all three isolates are considered to be members of the same species and data suggest it represents a novel genus and species in the order Clostridiales with an association with Clostridium rRNA cluster III within the family Ruminococcaceae. We propose the name, Mageeibacillus indolicus gen. nov., sp. nov. The type strain is BAA-2120T and CCUG 59143T.

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Mycoplasma, bacterial vaginosis–associated bacteria BVAB3, race, and risk of preterm birth in a high-risk cohort

Cited by 66 publications

References 20 publications

Epidemiologic Factors and Urogenital Infections Associated With Preterm Birth in a Midwestern U.S. Population

Epidemiologic Factors and Urogenital Infections Associated With Preterm Birth in a Midwestern U.S. Population

Replication and refinement of a vaginal microbial signature of preterm birth in two racially distinct cohorts of US women

Mageeibacillus indolicus gen. nov., sp. nov.: A novel bacterium isolated from the female genital tract

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