First trimester bacterial vaginosis, individual microorganism levels, and risk of second trimester pregnancy loss among urban women

Deborah B. Nelson, Scarlett Bellamy, Irving Nachamkin, Roberta B. Ness, George A. Macones, Lynne Allen-Taylor

Research output: Contribution to journalArticle

28 Scopus citations

Abstract

Objective: To examine the role of first trimester bacterial vaginosis (BV) and level of BV-associated microorganisms, diagnosed using the Nugent gram stain criteria and the risk of second trimester pregnancy loss among urban women. Design: Prospective cohort study. Setting: Urban prenatal care clinics. Patient(s): Women presenting for their first prenatal care visit who had completed 12 weeks gestation or less and resided within Philadelphia, Pennsylvania. Main Outcome Measure(s): Pregnancy loss. Result(s): Of 1948 women enrolled at a mean gestational age of 10 weeks (range 7.4 to 12.6 weeks), those with the highest level of BV-related vaginal flora alteration compared with women with normal vaginal flora had over a twofold increased risk of second trimester pregnancy loss after adjustment for confounders (adjusted hazard ratio [aHR] 2.49, 95% confidence interval [CI] 1.13 to 5.48). Low Lactobacillus spp. and the absence of Lactobacillus spp. were also significantly related to the risk of second trimester pregnancy loss (aHR 1.32, 95% CI 1.10-1.64; aHR 2.30, 95% CI 1.09-4.85; respectively). Conclusion(s): Overall BV positivity was not related to second trimester pregnancy loss. Comparing the highest to lowest tertile of BV positivity in early pregnancy conferred a two-fold increased risk of second trimester pregnancy loss and low amounts or the absence of Lactobacillus spp. in the first trimester also significantly increased the risk of second trimester pregnancy loss.

Original languageEnglish
Pages (from-to)1396-1403
Number of pages8
JournalFertility and Sterility
Volume88
Issue number5
DOIs
StatePublished - Nov 1 2007

Keywords

  • Bacterial vaginosis
  • Lactobacillus spp.
  • second trimester pregnancy loss

Fingerprint Dive into the research topics of 'First trimester bacterial vaginosis, individual microorganism levels, and risk of second trimester pregnancy loss among urban women'. Together they form a unique fingerprint.

  • Cite this