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Mycoplasma, bacterial vaginosis-associated bacteria BVAB3, race, and risk of preterm birth in a high-risk cohort.
Am J Obstet Gynecol. 2014 Mar; 210(3):226.e1-7.AJ

Abstract

OBJECTIVE

Genital tract infection accounts for approximately 25-40% of all preterm births. We sought to assess the relationship between preterm birth and selected vaginal bacterial taxa associated with preterm birth either directly or through their association with bacterial vaginosis (BV).

STUDY DESIGN

Vaginal fluid for Gram stain was collected between 17 and 22 weeks' gestation as part of a randomized trial of ultrasound-indicated cerclage for preterm birth prevention in women at high risk for recurrent spontaneous preterm birth. Bacterial deoxyribonucleic acid was extracted from the Gram stain slides and analyzed using quantitative polymerase chain reaction.

RESULTS

Among the 499 participants, Mycoplasma was positively correlated with increased risk of preterm (risk ratio [RR], 1.83; 95% confidence interval [CI], 1.52-2.22) as was Mobiluncus (RR, 1.36; 95% CI, 1.07-1.73) and Atopobium (RR, 1.44; 95% CI, 1.1-1.87). However, there were strong interactions between the race/ethnic group and the presence of these and other individual taxa on risk of preterm birth. By contrast, bacterial vaginosis-associated bacteria (BVAB)-3 was consistently associated with a reduction in the risk of preterm birth for all racial/ethnic groups (0.55; 95% CI, 0.39-0.78).

CONCLUSION

BV is characterized by a reduction of Lactobacillus, and lactic acid-producing bacteria and the presence of Mobiluncus; we found these factors and the presence of Mycoplasma to be associated with an increased risk of preterm birth. By contrast, the presence of a recently identified organism sufficient to cause BV, BVAB3, decreased the risk of preterm birth. These findings give insight into why treating BV has mixed impact on risk of preterm birth.

Authors+Show Affiliations

Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI. Electronic address: bfoxman@umich.edu.Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI.Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI.Department of Ecology and Evolutionary Biology, University of Michigan Medical School, Ann Arbor, MI.Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI.Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The University of Alabama at Birmingham, Birmingham, AL.Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of California at Irvine School of Medicine, Irvine, CA.Department of Family Medicine and Public Health Sciences, School of Medicine, Wayne State University, Detroit, MI.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

24096128

Citation

Foxman, Betsy, et al. "Mycoplasma, Bacterial Vaginosis-associated Bacteria BVAB3, Race, and Risk of Preterm Birth in a High-risk Cohort." American Journal of Obstetrics and Gynecology, vol. 210, no. 3, 2014, pp. 226.e1-7.
Foxman B, Wen A, Srinivasan U, et al. Mycoplasma, bacterial vaginosis-associated bacteria BVAB3, race, and risk of preterm birth in a high-risk cohort. Am J Obstet Gynecol. 2014;210(3):226.e1-7.
Foxman, B., Wen, A., Srinivasan, U., Goldberg, D., Marrs, C. F., Owen, J., Wing, D. A., & Misra, D. (2014). Mycoplasma, bacterial vaginosis-associated bacteria BVAB3, race, and risk of preterm birth in a high-risk cohort. American Journal of Obstetrics and Gynecology, 210(3), e1-7. https://doi.org/10.1016/j.ajog.2013.10.003
Foxman B, et al. Mycoplasma, Bacterial Vaginosis-associated Bacteria BVAB3, Race, and Risk of Preterm Birth in a High-risk Cohort. Am J Obstet Gynecol. 2014;210(3):226.e1-7. PubMed PMID: 24096128.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Mycoplasma, bacterial vaginosis-associated bacteria BVAB3, race, and risk of preterm birth in a high-risk cohort. AU - Foxman,Betsy, AU - Wen,Ai, AU - Srinivasan,Usha, AU - Goldberg,Deborah, AU - Marrs,Carl F, AU - Owen,John, AU - Wing,Deborah A, AU - Misra,Dawn, Y1 - 2013/10/04/ PY - 2013/06/18/received PY - 2013/09/11/revised PY - 2013/10/02/accepted PY - 2013/10/8/entrez PY - 2013/10/8/pubmed PY - 2014/5/6/medline KW - bacterial vaginosis KW - genital tract infection KW - preterm birth KW - vaginal bacterial taxa SP - 226.e1 EP - 7 JF - American journal of obstetrics and gynecology JO - Am J Obstet Gynecol VL - 210 IS - 3 N2 - OBJECTIVE: Genital tract infection accounts for approximately 25-40% of all preterm births. We sought to assess the relationship between preterm birth and selected vaginal bacterial taxa associated with preterm birth either directly or through their association with bacterial vaginosis (BV). STUDY DESIGN: Vaginal fluid for Gram stain was collected between 17 and 22 weeks' gestation as part of a randomized trial of ultrasound-indicated cerclage for preterm birth prevention in women at high risk for recurrent spontaneous preterm birth. Bacterial deoxyribonucleic acid was extracted from the Gram stain slides and analyzed using quantitative polymerase chain reaction. RESULTS: Among the 499 participants, Mycoplasma was positively correlated with increased risk of preterm (risk ratio [RR], 1.83; 95% confidence interval [CI], 1.52-2.22) as was Mobiluncus (RR, 1.36; 95% CI, 1.07-1.73) and Atopobium (RR, 1.44; 95% CI, 1.1-1.87). However, there were strong interactions between the race/ethnic group and the presence of these and other individual taxa on risk of preterm birth. By contrast, bacterial vaginosis-associated bacteria (BVAB)-3 was consistently associated with a reduction in the risk of preterm birth for all racial/ethnic groups (0.55; 95% CI, 0.39-0.78). CONCLUSION: BV is characterized by a reduction of Lactobacillus, and lactic acid-producing bacteria and the presence of Mobiluncus; we found these factors and the presence of Mycoplasma to be associated with an increased risk of preterm birth. By contrast, the presence of a recently identified organism sufficient to cause BV, BVAB3, decreased the risk of preterm birth. These findings give insight into why treating BV has mixed impact on risk of preterm birth. SN - 1097-6868 UR - https://www.unboundmedicine.com/medline/citation/24096128/Mycoplasma_bacterial_vaginosis_associated_bacteria_BVAB3_race_and_risk_of_preterm_birth_in_a_high_risk_cohort_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9378(13)01041-7 DB - PRIME DP - Unbound Medicine ER -