This article is more than 5 years old. Information may no longer be current.
A. vaginae, G. vaginalis linked to preterm birth, miscarriage
In high-risk pregnancies, high vaginal loads of Atopobium vaginae and Gardnerella vaginalis have been linked to late miscarriage and preterm birth, according to researchers in France.
“Preterm birth is still increasing in most countries,” the researchers wrote in Clinical Infectious Diseases. “Recently, a decrease has been reported in the US, especially among late preterm births. Nevertheless, among early deliveries, infection-related preterm birth remains mostly unchanged. Infection and dysbiosis are one target in the effort to stem this rise.”
In a prospective, multicenter study, the researchers evaluated 813 pregnant women receiving prenatal care at eight university hospitals in France. The women were aged 18 years or older, with a gestational age of 14 to 28 weeks, and were at risk for premature delivery due to a short cervix or having a history of preterm delivery or late miscarriage.
The researchers conducted real-time PCR analysis to identify certain species of pathogens, including Lactobacillus spp., A. vaginae, G. vaginalis and Mycoplasma hominis, as well as the human albumin gene.
In their analyses, they found that preterm delivery was significantly associated with high vaginal loads of either or both A. vaginae and G. vaginalis (HR=3.9; 95% CI, 1.1-14.1). In particular, in women with premature delivery between 22 and 32 weeks, and higher vs. lower vaginal loads of A. vaginae were associated with a significantly shorter time to delivery. In women who gave birth before 22 weeks, the mean time to delivery was 152.2 days (HR=5.6; 95% CI, 1.5-21.3). In women who gave birth before 28 weeks, the mean time to delivery was 149 days (HR=2.8; 95% CI, 1.1-8.2). Finally, in women who gave birth before 32 weeks, the mean time to delivery was 132.6 days (HR=2.2; 95% CI, 1.1-4.6). Multivariate analysis indicated a persistent association between A. vaginae concentrations greater than 108/mL and delivery before 22 weeks of gestation (adjusted HR=4.7; 95% CI, 0.2-17.6).
“The association between preterm birth and A. vaginae may be very important, for as of now, no trials of either antibiotics or tocolytics during preterm labor have successfully and consistently prolonged pregnancy,” the researchers wrote.
The researchers said these findings, however, may be used to predict patients who may be at greater risk for preterm birth.
“A high vaginal load of A. vaginae identifies a population at high risk of preterm birth,” the researchers wrote. “Further studies that both screen for and then treat A. vaginae are needed.”
Disclosure: The researchers report no relevant financial disclosures.