Imperial College London
Alternate

DrVassoTerzidou

Faculty of Medicine, Department of Metabolism, Digestion and Reproduction

Clinical Reader in Obstetrics and Gynaecology
 
 
 
//

Contact

 

+44 (0)20 7594 2164v.terzidou

 
 
//

Location

 

Institute of Reproductive and Developmental BiologyHammersmith Campus

//

Summary

 

Publications

Citation

BibTex format

@article{MacIntyre:2018:10.1186/s12916-017-0999-x,
author = {MacIntyre, DA and Brown, R and Marchesi, J and Lee, Y and Smith, A and Lehne, B and Kindinger, L and Terzidou, V and Holmes, E and Nicholson, J and Bennett, P},
doi = {10.1186/s12916-017-0999-x},
journal = {BMC Medicine},
title = {Vaginal dysbiosis increases risk of preterm fetal membrane rupture, neonatal sepsis and is exacerbated by erythromycin},
url = {http://dx.doi.org/10.1186/s12916-017-0999-x},
volume = {16},
year = {2018}
}
Download

RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Background: Preterm prelabour rupture of the fetal membranes (PPROM) precedes 30% of preterm births  and  is  a  risk  factor  for  early  onset  neonatal  sepsis. As PPROM  is  strongly  associated  with ascending  vaginal  infection prophylactic antibiotics are  widely  used. The  evolution  of  vaginal microbiota   composition   associated   with   PPROM and   the   impact   of   antibiotics on   bacterial composition  is  unknown. Methods: We prospectively assessed  vaginal  microbiota  prior to and following  PPROM using  MiSeq-based  sequencing  of  16S  rRNA gene  amplicons and examined the impact of erythromycin prophylaxis on bacterial load and community structures.Results: In contrast to  pregnancies  delivering  at  term,  vaginal  dysbiosis  characterised  by Lactobacillus spp.  depletion, was  present  prior  to  the  rupture  of  fetal  membranes  in  approximately  a  third  of  cases  (0%  versus 27%, P= 0.026) and persisted following membrane rupture (31%, P= 0.005). Vaginal dysbiosis was exacerbated by erythromycin treatment (47%, P= 0.00009) particularly in women initially colonised by Lactobacillus species. Lactobacillus depletion and increased relative abundance of Sneathia spp. was  associated  with  subsequent  funisitis  and  early  onset  neonatal  sepsis. Conclusions:Our  data show  that  vaginal  microbiota  composition  is  a risk-factor  for  subsequent  PPROM  and  is  associated with  adverse  short-term  maternal  and  neonatal  outcomes. This highlights vaginal  microbiota  as a potentially modifiable antenatal risk factor for PPROM and suggests that routine use of erythromycin for PPROM be re-examined.
AU  - MacIntyre,DA
AU  - Brown,R
AU  - Marchesi,J
AU  - Lee,Y
AU  - Smith,A
AU  - Lehne,B
AU  - Kindinger,L
AU  - Terzidou,V
AU  - Holmes,E
AU  - Nicholson,J
AU  - Bennett,P
DO  - 10.1186/s12916-017-0999-x
PY  - 2018///
SN  - 1741-7015
TI  - Vaginal dysbiosis increases risk of preterm fetal membrane rupture, neonatal sepsis and is exacerbated by erythromycin
T2  - BMC Medicine
UR  - http://dx.doi.org/10.1186/s12916-017-0999-x
UR  - https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-017-0999-x
UR  - http://hdl.handle.net/10044/1/55525
VL  - 16
ER  -
Download