Is there a role for probiotics in the prevention of preterm birth?
Preterm birth (PTB) continues to be a global health challenge. An over-production of inflammatory cytokines and chemokines, as well as an altered maternal vaginal microbiome has been implicated in the pathogenesis of inflammation/infection-associated PTB. Lactobacillus represents the dominant species in the vagina of most healthy pregnant women. The depletion of Lactobacillus in women with bacterial vaginosis (BV) has been associated with an increased risk of PTB. It remains unknown at what point an aberrant vaginal microbiome composition specifically induces the cascade leading to PTB. The ability of oral or vaginal lactobacilli probiotics to reduce BV occurrence and/or dampen inflammation is being considered as a means to prevent PTB. Certain anti-inflammatory properties of lactobacilli suggest potential mechanisms. To date, clinical studies have not been powered with sufficiently high rates of PTB, but overall, there is merit in examining this promising area of clinical science.
Department of Physiology, Obstetrics and Gynecology, University of Toronto , Toronto, ON , Canada ; Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital , Toronto, ON , Canada.
Siwen
S
Yang
Department of Microbiology and Immunology, Western University , London, ON , Canada ; Lawson Health Research Institute , London, ON , Canada.
Gregor
G
Reid
Department of Physiology, Obstetrics and Gynecology, University of Toronto , Toronto, ON , Canada ; Department of Obstetrics and Gynecology, The University of Western Australia , Perth, WA , Australia.
John R G
JR
Challis
Department of Microbiology and Immunology, Western University , London, ON , Canada ; Lawson Health Research Institute , London, ON , Canada.
Sung O
SO
Kim
Department of Biochemistry, Western University , London, ON , Canada.
Gregory B
GB
Gloor
Department of Physiology, Obstetrics and Gynecology, University of Toronto , Toronto, ON , Canada ; Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital , Toronto, ON , Canada.
Alan D
AD
Bocking
bacterial vaginosis; cytokines; infection and inflammation; preterm birth; probiotics; vaginal microbiome