Subtle changes to the microbiome in the vagina of pregnant women have been tied to pre-term labor in a recent study carried out by the Imperial College London.
The study, published in the journal BMC Medicine, highlights the importance of the role of Lactobacillus bacteria in reproductive health.
Lactobacillus is the bacteria contained in our live biotherapuetic, LACTIN-V™, which is designed to combat the pathogenic bacteria and dysbiosis observed in bacterial vaginosis and urinary tract infections by fostering the conditions observed in healthy women.
Previous research has shown that over the course of pregnancy, the bacteria that colonize the vagina become less diverse and are dominated chiefly by Lactobacillus.
Analysis of samples collected from 250 women in the Imperial College study revealed that premature membrane rupture (before 37 weeks) was associated with a drop in Lactobacillus and an increase in other types of bacteria, including potentially harmful bugs such as Staphylococcus and Streptococcus. Samples from mothers of newborns who developed sepsis following delivery also contained less Lactobacillus and a greater diversity of other bacteria, including Streptococcus and E. coli.
“This study is one of the first to show that around almost a half of pregnant women may have an unbalanced vaginal microbiota before premature rupture, providing further evidence of the role of bacteria in some cases of premature births,” says lead author David MacIntyre.
The study also found that the standard antibiotic treatment given to women whose waters break early could actually be detrimental for a subset of women.
The researchers explain that for a small proportion of women the treatment, administered as a protective measure in hospital, can disrupt the balance of the mother’s microbes by eradicating the ‘good’ bacteria and allowing more harmful bacteria to take their place.
“The aim of antibiotic treatment in premature rupture of membrane is to reduce the risk of ascending infection. Our results suggest that a more personalized approach targeting only those women likely to benefit from antibiotics may prove more beneficial than the current ‘one treatment fits all’ approach, says Richard Brown, a Clinical Research Fellow at Imperial and first author of the study.
Brown suggests that further studies be conducted to assess current clinical guidelines for women with premature rupture and alternative treatments.
Several clinical trials with LACTIN-V have demonstrated that LACTIN-V use is associated with favorable outcomes for patients with bacterial vaginosis and recurrent urinary tract infections. A trial has also been launched in collaboration with five Danish fertility clinics and Statens Serum Institute to determine whether LACTIN-V can improve the success rate of in vitro fertilization (IVF) for infertile women with abnormal vaginal microbiota (AVM).