Imperial College London
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Professor David MacIntyre

Faculty of Medicine, Department of Metabolism, Digestion and Reproduction

Professor in Reproduction Systems Medicine
 
 
 
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Contact

 

+44 (0)20 7594 2195d.macintyre Website

 
 
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Location

 

Institute of Reproductive and Developmental BiologyHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Kindinger:2017:10.1186/s40168-016-0223-9,
author = {Kindinger, LM and Bennett, PR and Lee, YS and Marchesi, JR and Smith, A and Cacciatore, S and Holmes, E and Nicholson, JK and Teoh, TG and MacIntyre, DA},
doi = {10.1186/s40168-016-0223-9},
journal = {Microbiome},
pages = {1--14},
title = {The interaction between vaginal microbiota, cervical length and vaginal progesterone treatment for preterm birth risk},
url = {http://dx.doi.org/10.1186/s40168-016-0223-9},
volume = {5},
year = {2017}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Background:Preterm birth is the primary cause of infant death worldwide. A short cervix in the  second  trimester  of  pregnancy  is  a  risk  factor  for preterm  birth. In  specific  patient cohorts, vaginal  progesterone reduces this  risk. Using  16S  rRNA  gene  sequencing we undertook  a  prospective  study  in  women  at  risk  of preterm  birth(n=161)  to  assess  1)  the relationship  between  vaginal  microbiotaand  cervical  length in  the  second  trimester  and preterm   birth-risk,   and 2)   the   impact   of   vaginal   progesterone   on   vaginal bacterial communities in women with a short cervix.Results:Lactobacillus iners dominance  at 16  weeks gestation was significantly associated with both  a  short  cervix <25mm (n=15, P<0.05), andpreterm  birth <34+0 weeks (n=18, 38P<0.01;  69% PPV).In  contrast, L.  crispatus dominance was highly  predictive  of  term  birth (n=127, 98% PPV). Cervical shortening and preterm birthwere not associated with vaginal dysbiosis. A longitudinal characterization  of vaginal microbiota (<18,  22, 28  and  34  weeks)was  then  undertaken in women receiving  vaginal  progesterone  (400mg/OD,  n=25) versus controls (n=42).Progesterone did not alter vaginal bacterial community structurenor reduce L. iners-associated preterm birth  (<34 weeks). Conclusions:L.  iners dominance  of the  vaginal  microbiota at  16  weeks  gestation  is  a  risk factor for preterm birth, whereas L. crispatus dominance is protective against preterm birth. Vaginal progesterone does not appear to impact the pregnancy vaginal microbiota. Patients and clinicians who may be concerned about ‘infection risk’ associated with use of a vaginal pessary during high-risk pregnancy can be reassured.
AU  - Kindinger,LM
AU  - Bennett,PR
AU  - Lee,YS
AU  - Marchesi,JR
AU  - Smith,A
AU  - Cacciatore,S
AU  - Holmes,E
AU  - Nicholson,JK
AU  - Teoh,TG
AU  - MacIntyre,DA
DO  - 10.1186/s40168-016-0223-9
EP  - 14
PY  - 2017///
SN  - 2049-2618
SP  - 1
TI  - The interaction between vaginal microbiota, cervical length and vaginal progesterone treatment for preterm birth risk
T2  - Microbiome
UR  - http://dx.doi.org/10.1186/s40168-016-0223-9
UR  - https://microbiomejournal.biomedcentral.com/articles/10.1186/s40168-016-0223-9
UR  - http://hdl.handle.net/10044/1/43266
VL  - 5
ER  -
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