title: First Trimester Levels of BV-Associated Bacteria and Risk of Miscarriage Among Women Early in Pregnancy.
abstract: OBJECTIVE
  Prior studies have examined the role of bacterial vaginosis (BV) and increased risk of miscarriage; however the risk has been modest and many BV positive pregnant women deliver at term. BV is microbiologically heterogeneous, and thus the identification of specific BV-associated bacteria associated with miscarriage is warranted.
  
  
  METHODS
  We measured the presence and level of seven BV-associated bacteria prior to 14 weeks gestation among urban pregnant women seeking routine prenatal care at five urban obstetric practices at Temple University Hospital in Philadelphia PA from July 2008 through September 2011. 418 Pregnant women were included in this assessment and 74 experienced a miscarriage.
  
  
  RESULTS
  Mean log concentration of BVAB3 was significantly higher among women experiencing a miscarriage (4.27 vs. 3.71, p value = 0.012). Younger women with high levels of BVAB3 had the greatest risk of miscarriage. In addition, we found a significant decreased risk of miscarriage among women with higher log concentrations of Leptotrichia/Sneathia species or Megasphaera phylotype 1-like species early in pregnancy.
  
  
  CONCLUSIONS
  The identification of selected vaginal bacteria associated with an increased risk of miscarriage could support screening programs early in pregnancy and promote early therapies to reduce early pregnancy loss.
authors.affiliation: Department of Obstetrics and Gynecology, Temple University, Philadelphia, PA, USA. dnelson@temple.edu.|Department of Public Health, College of Health Professions and Social Work, Temple University, 1301 Cecil B Moore Avenue, Ritter Annex, Room 905, Philadelphia, PA, 19122, USA. dnelson@temple.edu.
authors.forename: Deborah B
authors.initials: DB
authors.lastname: Nelson
authors.affiliation: University of Pennsylvania School of Nursing, Room 479 Fagin Hall, 418 Curie Boulevard, Philadelphia, PA, 19104, USA. alhanlon@nursing.upenn.edu.
authors.forename: Alexandra L
authors.initials: AL
authors.lastname: Hanlon
authors.affiliation: Department of Statistics, Temple University, Philadelphia, PA, USA. tue70146@temple.edu.
authors.forename: Guojiao
authors.initials: G
authors.lastname: Wu
authors.affiliation: Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA. congzhou@fhcrc.org.|Division of Allergy and Infectious Diseases, Fred Hutchinson Cancer Research Center, University of Washington, 1100 Eastlake Ave, E4-100, Box 358080, Seattle, WA, 98109, USA. congzhou@fhcrc.org.
authors.forename: Congzhou
authors.initials: C
authors.lastname: Liu
authors.affiliation: Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA. dfredric@fhcrc.org.|Division of Allergy and Infectious Diseases, Fred Hutchinson Cancer Research Center, University of Washington, 1100 Eastlake Ave, E4-100, Box 358080, Seattle, WA, 98109, USA. dfredric@fhcrc.org.
authors.forename: David N
authors.initials: DN
authors.lastname: Fredricks
mesh_terms: D000022:Abortion, Spontaneous / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D062489:Health Impact Assessment / Q000706:statistics & numerical data; D006801:Humans; D045183:Leptotrichia / Q000472:pathogenicity; D045851:Megasphaera / Q000472:pathogenicity; D011247:Pregnancy; D011261:Pregnancy Trimester, First / Q000502:physiology*; D016585:Vaginosis, Bacterial / Q000150:complications / Q000453:epidemiology*
keywords: BVAB3; Leptotrichia/Sneathia species; Megasphaera phylotype 1-like species; Miscarriage