title: The vaginal microbiome, vaginal anti-microbial defence mechanisms and the clinical challenge of reducing infection-related preterm birth.
abstract: Ascending bacterial infection is implicated in about 40-50% of preterm births. The human vaginal microbiota in most women is dominated by lactobacilli. In women whose vaginal microbiota is not lactobacilli-dominated anti-bacterial defence mechanisms are reduced. The enhanced proliferation of pathogenic bacteria plus degradation of the cervical barrier increase bacterial passage into the endometrium and amniotic cavity and trigger preterm myometrial contractions. Evaluation of protocols to detect the absence of lactobaciili dominance in pregnant women by self-measuring vaginal pH, coupled with measures to promote growth of lactobacilli are novel prevention strategies that may reduce the occurrence of preterm birth in low-resource areas.
authors.affiliation: Division of Immunology and Infectious Diseases, Department of Obstetrics and Gynecology, Weill Cornell Medical College, New York, NY, USA.
authors.forename: S S
authors.initials: SS
authors.lastname: Witkin
mesh_terms: D005260:Female; D006801:Humans; D006863:Hydrogen-Ion Concentration; D019344:Lactic Acid / Q000032:analysis; D007778:Lactobacillus; D064307:Microbiota; D047928:Premature Birth / Q000382:microbiology* / Q000517:prevention & control*; D014621:Vagina / Q000737:chemistry* / Q000382:microbiology*; D016585:Vaginosis, Bacterial / Q000150:complications* / Q000175:diagnosis
chemical_list: D019344:Lactic Acid
keywords: Bacterial vaginosis; d-lactic acid; l-lactic acid; lactobacilli; preterm birth; vaginal microbiome