Preterm labor and bacterial vaginosis-associated bacteria among urban women

Aims: Bacterial vaginosis (BV) affects millions of women, is extremely prevalent and is frequently chronic. We recognize numerous microbiologic variations among women with BV and this variability may explain the limited effectiveness of metronidazole in curing BV and/or reducing the risk of spontaneous preterm birth (SPTB) among BV-positive pregnant women. We assessed the independent role of seven common BV-associated bacteria on the risk of spontaneous preterm birth (SPTB) among urban pregnant women. Methods: This prospective cohort study was conducted within an urban obstetrics practice at Temple University Hospital in Philadelphia, PA. Fifty pregnant women with documented singleton pregnancies between 25-36 weeks' gestation from February 2007 through June 2007 who presented to the Labor and Delivery Unit for evaluation of uterine contractions/preterm labor were enrolled. Results: We found that high median levels of Gardnerella vaginalis and low median levels of Lactobacillus crispatus were significantly predictive of SPTB. Slightly higher levels of Megasphaera-like species were also found among the group of women experiencing a SPTB during the follow-up period. Conclusions: Further identification of the individual attributable risk for separate BV-associated bacteria may be most useful in developing successful treatments to prevent SPTB among BV positive women.